Comparison of an advanced minimally invasive cardiac output monitoring with a continuous invasive cardiac output monitoring during lung transplantation.

The aim of this study was to compare a continuous non-calibrated left heart cardiac index (CI) measurement by arterial waveform analysis (FloTrac(®)/Vigileo(®)) with a continuous calibrated right heart CI measurement by pulmonary artery thermodilution (CCOmbo-PAC(®)/Vigilance II(®)) for hemodynamic...

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Publicado en:Journal of Clinical Monitoring & Computing Vol. 30; no. 4; pp. 475 - 481
Autores principales: Tomasi, Roland, Prueckner, Stephan, Czerner, Stephan, Schramm, Renè, Preissler, Gerhard, Zwißler, Bernhard, Dossow-Hanfstingl, Vera, von Dossow-Hanfstingl, Vera
Formato: research Journal Article
Publicado: Springer Nature Aug2016
Acceso en línea:Ver este registro en EBSCOhost
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      dt: Aug2016
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      pub: Springer Nature
      place: New York, New York
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        atl: Comparison of an advanced minimally invasive cardiac output monitoring with a continuous invasive cardiac output monitoring during lung transplantation.
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        au:
          Tomasi, Roland
          Prueckner, Stephan
          Czerner, Stephan
          Schramm, Renè
          Preissler, Gerhard
          Zwißler, Bernhard
          Dossow-Hanfstingl, Vera
          Schramm, Renè
          Zwißler, Bernhard
          von Dossow-Hanfstingl, Vera
        affil: Department of Anaesthesiology, University of Munich, Marchionistrasse 15 81377 Munich Germany
      sug:
        subj:
          Cardiac Output
          Intraoperative Monitoring Methods
          Lung Transplantation
          Pulmonary Artery Physiology
          Middle Age
          Adult
          Diagnosis, Cardiovascular Methods
          Human
          Aged
          Pilot Studies
          Intraoperative Monitoring Statistics and Numerical Data
          Thermodilution Statistics and Numerical Data
          Hemodynamics
          Male
          Linear Regression
          Thermodilution Methods
          Female
          Diagnosis, Cardiovascular Statistics and Numerical Data
          Prospective Studies
          Validation Studies
          Comparative Studies
          Evaluation Research
          Multicenter Studies
          Middle Aged: 45-64 years
          Adult: 19-44 years
          Aged: 65+ years
          Male
          Female
      ab: The aim of this study was to compare a continuous non-calibrated left heart cardiac index (CI) measurement by arterial waveform analysis (FloTrac(®)/Vigileo(®)) with a continuous calibrated right heart CI measurement by pulmonary artery thermodilution (CCOmbo-PAC(®)/Vigilance II(®)) for hemodynamic monitoring during lung transplantation. CI was measured simultaneously by both techniques in 13 consecutive lung transplants (n = 4 single-lung transplants, n = 9 sequential double-lung transplants) at distinct time points perioperatively. Linear regression analysis and Bland-Altman analysis with percentage error calculation were used for statistical comparison of CI measurements by both techniques. In this study the FloTrac(®) system underestimated the CI in comparison with the continuous pulmonary arterial thermodilution (p < 0.000). For all measurement pairs we calculated a bias of -0.55 l/min/m(2) with limits of agreement between -2.31 and 1.21 l/min/m(2) and a percentage error of 55 %. The overall correlations before clamping a branch oft the pulmonary artery (percentage error 41 %) and during the clamping periods of a branch oft the pulmonary artery (percentage error 66 %) failed to reached the required percentage error of less than 30 %. We found good agreement of both CI measurements techniques only during the measurement point "15 min after starting the second one-lung ventilation period" (percentage error 30 %). No agreement was found during all other measurement points. This pilot study shows for the first time that the CI of the FloTrac(®) system is not comparable with the continuous pulmonary-artery thermodilution during lung transplantation including the time periods without clamping a branch of the pulmonary artery. Arterial waveform and continuous pulmonary artery thermodilution are, therefore, not interchangeable during these complex operations.
      pubtype: Academic Journal
      doctype:
        research
        Journal Article
      ougenre: Article
    language: English
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