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Open Access 01-10-2012 | Research

The estimation of cardiac output by the Nexfin device is of poor reliability for tracking the effects of a fluid challenge

Authors: Xavier Monnet, Fabien Picard, Elsa Lidzborski, Malcie Mesnil, Jacques Duranteau, Christian Richard, Jean-Louis Teboul

Published in: Critical Care | Issue 5/2012

Abstract

Introduction

The Nexfin device estimates arterial pressure by the volume clamp method through a finger pneumatic cuff. It also allows to estimate cardiac index (CI_noninv) by pulse contour analysis of the non-invasive arterial pressure curve. We evaluated the ability of the device to track changes in cardiac index induced by a fluid challenge.

Methods

We included 45 patients for whom a volume expansion (500 mL of saline infused over 30 min) was planned. The volume expansion-induced changes in cardiac index measured by transpulmonary thermodilution (CI_inv, PiCCO device) and in CI_noninv were recorded.

Results

In seven patients, the Nexfin could not record the arterial curve due to finger hypoperfusion. Considering both the values obtained before and after volume expansion (n = 76 pairs of measurements), the bias (lower and upper limits of agreement) between CI_inv and CI_noninv was 0.2 (-1.8 to 2.2) L/min/m². The mean change in CI_noninv was 10 ± 11%. The percentage error of CI_noninv was 57%. The correlation between the changes in CI_inv and CI_noninv observed during volume expansion was significant (P = 0.0002) with an r² = 0.31.

Conclusions

The estimation of CI by the Nexfin device in critically ill patients is not reliable, neither for estimating absolute values of CI nor for tracking its changes during volume expansion.

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Title: The estimation of cardiac output by the Nexfin device is of poor reliability for tracking the effects of a fluid challenge
Authors: Xavier Monnet
Fabien Picard
Elsa Lidzborski
Malcie Mesnil
Jacques Duranteau
Christian Richard
Jean-Louis Teboul
Publication date: 01-10-2012
Publisher: BioMed Central
Published in: Critical Care / Issue 5/2012
Electronic ISSN: 1364-8535
DOI: https://doi.org/10.1186/cc11846

Keynote webinar | Spotlight on medication adherence

Springer Medicine

The estimation of cardiac output by the Nexfin device is of poor reliability for tracking the effects of a fluid challenge

Abstract

Introduction

Methods

Results

Conclusions

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Introduction

Methods

Results

Conclusions

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