Skip to main content
Key Specialties
Cardiology Diabetology Endocrinology Gastroenterology Geriatrics and Gerontology Gynecology and Obstetrics Hematology Infectious Disease Internal Medicine Nephrology Neurology Oncology Pediatrics Respiratory Medicine Rheumatology Surgery
Congress Coverage
2024 ACC Congress 2023 ESMO Congress 2023 EASD Congress 2023 ERS Congress 2023 ESC Congress
Clinical Collections
Advances in Alzheimer’s

At a glance: The STEP trials

A round-up of the STEP phase 3 clinical trials evaluating semaglutide for weight loss in people with overweight or obesity.
ADVANCED SEARCH
Log in
Top
Journal of Clinical Monitoring and Computing
Published in: Journal of Clinical Monitoring and Computing 2/2017

01-04-2017 | Original Research

Agreement in hemodynamic monitoring during orthotopic liver transplantation: a comparison of FloTrac/Vigileo at two monitoring sites with pulmonary artery catheter thermodilution

Authors: Matthew Lee, Laurence Weinberg, Brett Pearce, Nicholas Scurrah, David A. Story, Param Pillai, Peter R. McCall, Larry P. McNicol, Philip J. Peyton

Published in: Journal of Clinical Monitoring and Computing | Issue 2/2017

Login to get access

Abstract

To study agreement in cardiac index (CI), systemic vascular resistance index (Systemic VRI) and stroke volume variation (SV variation) between the FloTrac/Vigileo at radial and femoral arterial cannulation sites, and pulmonary artery catheter (PAC) thermodilution, in patients undergoing orthotopic liver transplantation. A prospective observational study of 25 adult patients with liver failure. Radial and femoral arteries were cannulated with standardised FloTrac/Vigileo arterial transducer kits and a PAC was inserted. CI, SV variation and Systemic VRI were measured four times (30 min after induction of anesthesia, 30 min after portal vein clamping, 30 min after graft reperfusion, 30 min after commencement of bile duct anastomosis). The bias, precision, limits of agreement (LOA) and percentage errors were calculated using Bland–Altman statistics to compare measurements from radial and femoral arterial cannulation sites and PAC thermodilution. Neither radial nor femoral CI achieved acceptable agreement with PAC CI [radial to PAC bias (SD) 1.17 (1.49) L/min/m2, percentage error 64.40 %], [femoral to PAC bias (SD) −0.71 (1.81) L/min/m2, percentage error 74.20 %]. Agreement between radial and femoral sites for CI [mean difference (SD) −0.43 (1.51) L/min/m2, percentage error 70.40 %] and Systemic VRI [mean difference (SD) 0.03 (4.17) LOA ±8.17 mmHg min m2/L] were also unacceptable. Agreement in SV variation between radial and femoral measurement sites approached a clinically acceptable threshold [mean difference (SD) 0.68 (2.44) %), LOA ±4.78 %]. FloTrac/Vigileo CI cannot substitute for PAC thermodilution CI, regardless of measurement site. SV variation measurements may be interchangeable between radial and femoral sites for determining fluid responsiveness.
Literature
1.
Lee M, Weinberg L, Pearce B, Scurrah N, Story DA, McCall PR, McNicol LP, Peyton PJ. Agreement between radial and femoral arterial blood pressure measurements during orthotopic liver transplantation. Crit Care Resusc. 2015;17:101–7.PubMed
2.
Kamath PS, Wiesner RH, Malinchoc M, Kremers W, Therneau TM, Kosberg CL, D’Amico G, Dickson ER, Kim WR. A model to predict survival in patients with end-stage liver disease. Hepatology. 2001;33:797–805.CrossRef
3.
Bland JM, Altman DG. Statistical methods for assessing agreement between two methods of clinical measurement. Lancet. 1986;1:307–10.CrossRefPubMed
4.
Bland JM, Altman DG. Agreement between methods of measurement with multiple observations per individual. J Biopharm Stat. 2007;17:571–82.CrossRefPubMed
5.
Critchley LA, Critchley JA. A meta-analysis of studies using bias and precision statistics to compare cardiac output measurement techniques. J Clin Monit Comput. 1999;15:85–91.CrossRefPubMed
6.
Critchley LA, Yang XX, Lee A. Assessment of trending ability of cardiac output monitors by polar plot methodology. J Cardiothorac Vasc Anesth. 2011;25:536–46.CrossRefPubMed
7.
Peyton PJ, Chong SW. Minimally invasive measurement of cardiac output during surgery and critical care: a meta-analysis of accuracy and precision. Anesthesiology. 2010;113:1220–35.CrossRefPubMed
8.
Peyton PJ, Chong SW. Bias and precision statistics: should we still adhere to the 30% benchmark for cardiac output monitor validation studies? Anesthesiology. 2011;114:1245–6.CrossRef
9.
Mayer J, Boldt J, Poland R, Peterson A, Manecke GR Jr. Continuous arterial pressure waveform-based cardiac output using the FloTrac/Vigileo: a review and meta-analysis. J Cardiothorac Vasc Anesth. 2009;23:401–6.CrossRefPubMed
10.
Krejci V, Vannucci A, Abbas A, Chapman W, Kangrga IM. Comparisons of calibrated and uncalibrated arterial pressure-based cardiac output monitors during orthotopic liver transplantation. Liver Transpl. 2010;16:773–82.PubMed
11.
Biancofiore G, Critchley L, Lee A, Yang XX, Bindi LM, Esposito M, Meacci L, Mozzo R, Filipponi F. Evaluation of a new software version of the FloTrac/Vigileo (Version 3.02) and a comparison with previous data in cirrhotic patients undergoing liver transplant surgery. Anesth Analg. 2011;113:515–22.PubMed
12.
Biancofiore G, Critchley L, Lee A, Bindi L, Bisa M, Esposito M, Meacci L, Mozzo R, DeSimone P, Urbani L, Filipponi F. Evaluation of an uncalibrated arterial pulse contour cardiac output monitoring system in cirrhotic patients undergoing liver surgery. Br J Anaesth. 2009;102(1):47–54.CrossRefPubMed
13.
Biais M, Souette-Gaulain K, Cottonceau V, Vallet A, Cochard JF, Revel P, Sztark F. Cardiac output measurement in patients undergoing liver transplantation: pulmonary artery catheter versus uncalibrated arterial pressure waveform analysis. Anesth Analg. 2008;106:1480–6.CrossRefPubMed
14.
Della Rocca G, Costa MG, Chiarandini P, Bertossi G, Lugano M, Pompei L, Coccia C, Sainz-Barriga M, Pietropaoli P. Arterial pulse cardiac output agreement with thermodilution in patients in hyperdynamic conditions. J Cardiothorac Vasc Anesth. 2008;22:681–7.CrossRefPubMed
15.
Staier K, Wiesenack C, Guenkel L, Keyl C. Cardiac output determination by thermodilution and arterial pulse waveform analysis in patients undergoing aortic valve replacement. Can J Anesth. 2008;55:22–8.CrossRefPubMed
16.
Vasdev S, Chauhan S, Choudhury M, Hote MP, Malik M, Kiran U. Arterial pressure waveform derived cardiac output FloTrac/Vigileo system (third generation software): comparison of two monitoring sites with the thermodilution cardiac output. J Clin Monit Comput. 2012;26:115–20.CrossRefPubMed
17.
Mehta Y, Chand RK, Sawhney R, Bhise M, Singh A, Trehan N. Cardiac output monitoring: comparison of a new arterial pressure waveform analysis to the bolus thermodilution technique in patients undergoing off-pump coronary artery bypass surgery. J Cardiothorac Vasc Anesth. 2008;22:394–9.CrossRefPubMed
18.
Schramm S, Albrecht E, Frascarolo P, Chassot P-G, Spahn DR. Validity of an arterial pressure waveform analysis device: does the puncture site play a role in the agreement with intermittent pulmonary artery catheter thermodilution measurements? J Cardiothorac Vasc Anesth. 2010;24:250–6.CrossRefPubMed
19.
De Backer D, Marx G, Tan A, Junker C, Can Nuffelen M, Hueter L, Ching W, Michard F, Vincent JL. Arterial pressure-based cardiac output monitoring: a multicentre validation of the third-generation software in septic patients. Intensive Care Med. 2011;37:233–40.CrossRefPubMed
20.
Compton FD, Zukunft B, Hoffmann C, Zidek W, Schaefer JH. Performance of a minimally invasive uncalibrated cardiac output monitoring system (FloTrac/Vigileo) in haemodynamically unstable patients. Br J Anaesth. 2008;100:451–6.CrossRefPubMed
21.
Metzelder S, Coburn M, Fries M, Reinges M, Reich S, Rossaint R, Marx G, Rex S. Performance of cardiac output measurement derived from arterial pressure waveform analysis in patients requiring high-dose vasopressor therapy. Br J Anaesth. 2011;106:776–84.CrossRefPubMed
22.
Kanazawa M, Fukuyama H, Kinefuchi Y, Takiguchi M, Suzuki T. Relationship between Aortic-to-radial arterial pressure gradient after cardiopulmonary bypass and changes in arterial elasticity. Anesthesiology. 2003;99:48–53.CrossRefPubMed
23.
Manecke GR, Parimucha M, Stratmann G, Wilson WC, Roth DM, Auger WR, Kerr KM, Jamieson SW, Kapelanski DP, Mitchel MM. Deep hypothermic circulatory arrest and the femoral-to-radial arterial pressure gradient. J Cardiothorac Vasc Anesth. 2004;18:175–9.CrossRefPubMed
24.
Dorman T, Breslow MJ, Lipsett PA. Radial artery pressure monitoring underestimates central arterial pressure during vasopressor therapy in critically ill surgical patients. Crit Care Med. 1998;26:1646–9.CrossRefPubMed
25.
Kim WY, Jun JH, Huh JW. Radial to femoral arterial blood pressure differences in septic shock patients receiving high-dose norepinephrine therapy. Shock. 2013;40:527–31.CrossRefPubMed
26.
Khwannimit B, Bhurayanontachai R. Prediction of fluid responsiveness in septic shock patients: comparing stroke volume variation by FloTrac/Vigileo and automated pulse pressure variation. Eur J Anaesthesiol. 2012;29:64–9.CrossRefPubMed
27.
Le Manach Y, Hofer CK, Lehot JJ, Vallet B, Goarin JP, Tavernier B, Cannesson M. Can changes in arterial pressure be used to detect changes in cardiac output during volume expansion in the perioperative period? Anesthesiology. 2012;117:1165–74.CrossRefPubMed
28.
Cannesson M, Le Manach Y, Hofer CK, Goarin JP, Lehot JJ, Vallet B, Tavernier B. Assessing the diagnostic accuracy of pulse pressure variations for the prediction of fluid responsiveness: a “gray zone” approach. Anesthesiology. 2011;115:231–41.CrossRefPubMed
29.
Kim YK, Shin WJ, Song JG, Jun IG, Kim HY, Seong SH, Hwang GS. Comparison of stroke volume variation derived from radial and femoral arterial pressure waveforms during liver transplantation. Transplant Proc. 2009;41:1220–4228.
30.
Thiele RH, Colquhoun DA, Tucker-Schwartz JM, Gillies GT, Durieux ME. Radial-femoral concordance in time and frequency domain-based estimates of systemic arterial respiratory variation. J Clin Monit Comput. 2012;26:393–400.CrossRefPubMed
Metadata
Title
Agreement in hemodynamic monitoring during orthotopic liver transplantation: a comparison of FloTrac/Vigileo at two monitoring sites with pulmonary artery catheter thermodilution
Authors
Matthew Lee
Laurence Weinberg
Brett Pearce
Nicholas Scurrah
David A. Story
Param Pillai
Peter R. McCall
Larry P. McNicol
Philip J. Peyton
Publication date
01-04-2017
Publisher
Springer Netherlands
Published in
Journal of Clinical Monitoring and Computing / Issue 2/2017
Print ISSN: 1387-1307
Electronic ISSN: 1573-2614
DOI
https://doi.org/10.1007/s10877-016-9840-x

Other articles of this Issue 2/2017

Journal of Clinical Monitoring and Computing 2/2017 Go to the issue

Original Research

Eye lens dosimetry in anesthesiology: a prospective study

Brief Communication

Falsely low values of oxygen saturation measured by pulse oximetry in a boy treated with Chinese herb tea

Original Research

FLOW-i ventilator performance in the presence of a circle system leak

Original Research

Perioperative risk factors and cumulative duration of “triple-low” state associated with worse 30-day mortality of cardiac valvular surgery

Review Paper

A sneak peek into digital innovations and wearable sensors for cardiac monitoring

Original Research

Practice patterns in the intraoperative use of bispectral index monitoring