Cardiac output and stroke volume variation measured by the pulse wave transit time method: a comparison with an arterial pressure-based cardiac output system
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Hemodynamic monitoring is mandatory for perioperative management of cardiac surgery. Recently, the estimated continuous cardiac output (esCCO) system, which can monitor cardiac output (CO) non-invasively based on pulse wave transit time, has been developed. Patients who underwent cardiovascular surgeries with hemodynamics monitoring using arterial pressure-based CO (APCO) were eligible for this study. Hemodynamic monitoring using esCCO and APCO was initiated immediately after intensive care unit admission. CO values measured using esCCO and APCO were collected every 6 h, and stroke volume variation (SVV) data were obtained every hour while patients were mechanically ventilated. Correlation and Bland–Altman analyses were used to compare APCO and esCCO. Welch’s analysis of variance, and four-quadrant plot and polar plot analyses were performed to evaluate the effect of time course, and the trending ability. A p-value < 0.05 was considered statistically significant. Twenty-one patients were included in this study, and 143 and 146 datasets for CO and SVV measurement were analyzed. Regarding CO, the correlation analysis showed that APCO and esCCO were significantly correlated (r = 0.62), and the bias ± precision and percentage error were 0.14 ± 1.94 (L/min) and 69%, respectively. The correlation coefficient, bias ± precision, and percentage error for SVV evaluation were 0.4, − 3.79 ± 5.08, and 99%, respectively. The time course had no effects on the biases between CO and SVV. Concordance rates were 80.3 and 75.7% respectively. While CO measurement with esCCO can be a reliable monitor after cardiovascular surgeries, SVV measurement with esCCO may require further improvement.
KeywordsNon-invasive hemodynamic monitoring Cardiovascular surgery patient Perioperative management Estimated continuous cardiac output Arterial pressure-based cardiac output
We are grateful to the management of Nihon Kohden Corporation, Japan, who kindly provided equipment.
Compliance with ethical standards
Conflict of interest
Dr. Hiroshi Morisaki received a research fund from Nihon Kohden Corporation (Tokyo, Japan). The funding institution played no role in this study. The other authors have no conflicts of interest to declare.
- 1.Harvey S, Harrison DA, Singer M, Ashcroft J, Jones CM, Elbourne D, Brampton W, Williams D, Young D, Rowan K. Assessment of the clinical effectiveness of pulmonary artery catheters in management of patients in intensive care (PAC-Man): a randomized controlled trial. Lancet. 2005;366:472–7.CrossRefPubMedGoogle Scholar
- 6.Smetkin AA, Hussain A, Fot EV, Zakharvov VI, Izotova NN, Yudina AS, Dityateva ZA, Gromova YV, Kuzkov VV, Bjertnaes LJ, Kirov MY. Estimated continuous cardiac output based on pulse wave transit time in off-pump coronary artery bypass grafting: a comparison with transpulmonary thermodilution. J Clin Monit Comput. 2017;31:361–70.CrossRefPubMedGoogle Scholar
- 7.Magliocca A, Rezoagli E, Anderson TA, Burns SM, Ichinose F, Chitilian HV. Cardiac output measurements based on the pulse wave transit time and thoracic impedance exhibit limited agreement with thermodilution method during orthotopic liver transplantation. Anesth Analg. 2018;126:85–92.CrossRefPubMedGoogle Scholar
- 8.Bataille B, Bertuit M, Mora M, Mazerolles M, Cocataille B, Bertuit M, Mora M, Mazerolles M, Cocuet P, Masson B, Moussot PE, Ginot J, Silva S, Larche J. Comparison of esCCO and transthoracic echocardiography for non-invasive measurement of cardiac output intensive care. Br J Anaesth. 2012;109:879–86.CrossRefPubMedGoogle Scholar
- 12.Yamada T, Tsutsui M, Sugo Y, Akazawa T, Sato N, Yamashita K, Ishihara H, Takeda J. Multicenter study verifying a method of noninvasive continuous cardiac output measurement using pulse wave transit time: a comparison with intermittent bolus thermodilution cardiac output. Anesth Analg. 2012;115:82–7.CrossRefPubMedGoogle Scholar
- 17.Terada T, Oiwa A, Maemura Y, Robert S, Kessoku S, Ochiai R. Comparison of the ability of two continuous cardiac output monitors to measure trends in cardiac output: estimated continuous cardiac output measured by modified pulse wave transit time and an arterial pulse contour-based cardiac output device. J Clin Monit Comput. 2016;30:621–7.CrossRefPubMedGoogle Scholar
- 18.Dache S, Van Rompaey N, Joosten A, Desebbe O, Saxena S, Eynden FV, Van Aelbrouck C, Huybrechts I, Obbergh LV, Barvais L. Comparison of the ability of esCCO and volume view to measure trends in cardiac output in patients undergoing cardiac surgery. Anaesthesiol Intensive Ther. 2017;49:175–80.CrossRefPubMedGoogle Scholar
- 19.Ishihara H, Sugo Y, Tsutsui M, Yamada T, Sato N, Akazawa T, Sato N, Yamashita K, Takeda J. The ability of a new continuous cardiac output monitor to measure trends in cardiac output following implementation of a patient information calibration and an automated exclusion algorithm. J Clin Monit Comput. 2012;26:465–71.CrossRefPubMedPubMedCentralGoogle Scholar
- 21.Feissel M, Aho LS, Georgiev S, Trapponnier R, Badie J, Bruyere R, Quenot JP. Pulse wave transit time measurements of cardiac output in septic shock patients: a comparison of the estimated continuous cardiac output system with transthoracic echocardiography. PLoS ONE. 2015;10:e0130489.CrossRefPubMedPubMedCentralGoogle Scholar