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Journal of Clinical Monitoring and Computing
Published in: Journal of Clinical Monitoring and Computing 1/2018

01-02-2018 | Original Research

Cross-comparisons of trending accuracies of continuous cardiac-output measurements: pulse contour analysis, bioreactance, and pulmonary-artery catheter

Authors: Bouchra Lamia, Hyung Kook Kim, Donald A. Severyn, Michael R. Pinsky

Published in: Journal of Clinical Monitoring and Computing | Issue 1/2018

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Abstract

We compared the similarity of cardiac-output (CO) estimates between available bolus thermodilution pulmonary-artery catheters (PAC), arterial pulse-contour analysis (LiDCOplus™, FloTrac™ and PiCCOplus™), and bioreactance (NICOM™). Repetitive simultaneous estimates of CO obtained from the above devices were compared in 21 cardiac-surgery patients during the first 2 h post-surgery. Mean and absolute values for CO across the devices were compared by ANOVA, Bland–Altman, Pearson moment, and linear-regression analyses. Twenty-one simultaneous CO measurements were made before and after therapeutic interventions. Mean PAC CO (5.7 ± 1.5 L min) was similar to LiDCO™, FloTrac™, PiCCO™, and NICOM™ CO (6.0 ± 1.9, 5.9 ± 1.0, 5.7 ± 1.8, 5.3 ± 1.0 L min, respectively). Mean CO bias between each paired method was −0.10 (PAC–LiDCO), 0.18 (PAC–PiCCO), −0.40 (PAC–FloTrac), −0.71 (PAC–NICOM), 0.28 (LiDCO–PiCCO), 0.39 (LiDCO–FloTrac), −0.97 (NICOM–LiDCO), 0.61 (PiCCO–FloTrac), −1.0 (NICOM–FloTrac), −0.73 (NICOM–PiCCO) L/min, with limits of agreement (1.96 SD, ±95% CI) of ± 2.01, ±2.35, ±2.27, ±2.70, ±1.97, ±2.17, ±3.51, ±2.87, ±2.40, and ± 3.14 L min, respectively, and the percentage error for each of the paired devices was 35, 41, 40, 47, 33, 36, 59, 50, 42, and 55%, respectively. From Pearson moment analysis, dynamic changes in CO, estimated by each device, showed good cross-correlations. Although all devices studied recorded similar mean CO values, which dynamically changed in similar directions, they have markedly different bias and precision values relative to each other. Thus, results from prior studies that have used one device to estimate CO cannot be used to validate others devices.
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Metadata
Title
Cross-comparisons of trending accuracies of continuous cardiac-output measurements: pulse contour analysis, bioreactance, and pulmonary-artery catheter
Authors
Bouchra Lamia
Hyung Kook Kim
Donald A. Severyn
Michael R. Pinsky
Publication date
01-02-2018
Publisher
Springer Netherlands
Published in
Journal of Clinical Monitoring and Computing / Issue 1/2018
Print ISSN: 1387-1307
Electronic ISSN: 1573-2614
DOI
https://doi.org/10.1007/s10877-017-9983-4

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