A comparison of pulse contour wave analysis and ultrasonic cardiac output monitoring in the critically ill

Udy, A. A., Altukroni, M., Jarrett, P., Roberts, J. A. and Lipman, J. (2012) A comparison of pulse contour wave analysis and ultrasonic cardiac output monitoring in the critically ill. Anaesthesia and Intensive Care, 40 4: 631-637.

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Author Udy, A. A.
Altukroni, M.
Jarrett, P.
Roberts, J. A.
Lipman, J.
Title A comparison of pulse contour wave analysis and ultrasonic cardiac output monitoring in the critically ill
Journal name Anaesthesia and Intensive Care  (ERA 2012 Listed)    (ERA 2010 Rank C)   Check publisher's open access policy
Publication date 2012-07
Sub-type Article
Volume number 40
Issue number 4
ISSN 0310-057X
1448-0271
Start page 631
End page 637
Total pages 7
Place of publication Edgecliff, NSW, Australia
Publisher Australian Society of Anaesthetists
Collection year 2013
Language eng
Formatted abstract Cardiac output (CO) is a key determinant of major organ blood flow and solute delivery to drug eliminating organs. As such, CO assessment is a key covariate in understanding altered drug handling in the critically ill. Newer minimally-invasive devices are providing unique platforms for such an application, although comparison data are currently lacking. In this study we evaluated the Vigileo® (Edwards Lifesciences, Irvine, CA, USA) and USCOM® (USCOM Ltd, Sydney, NSW) devices in 62 critically ill patients requiring antibacterial therapy. The mean COVigileo and COUSCOM for the first paired measurements were 8.20±2.65 l/minute and 6.84±2.57 l/minute respectively (P <0.001). A significant correlation was evident in all patients (r=0.537, P <0.001) although the recorded bias was large (1.36±2.51 l/minute, limits of agreement -3.6 to +6.3 l/minute). The overall percentage error was 65%. There was an improved correlation in those admitted with sepsis (r=0.639, P <0.001), compared to trauma (r=0.373, P=0.066), although bias, precision and percentage error were similar in both subgroups. In 54 patients a second paired assessment was obtained at three hours. A weak, although significant correlation (r=0.377, P=0.005) was observed suggesting that gross trends over time were similar. In conclusion, our findings demonstrate poor agreement between these techniques suggesting that these devices are not simply interchangeable when assessing CO in a research or clinical setting.
Keyword Cardiac output monitoring
Pulse contour wave analysis
Pulmonary-artery catheter
Transesophageal echocardiography
Q-Index Code C1
Q-Index Status Confirmed Code
Institutional Status UQ

Document type: Journal Article
Sub-type: Article
Collections: Official 2013 Collection
School of Medicine Publications
 
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Created: Tue, 25 Sep 2012, 13:08:31 EST by Matthew Lamb on behalf of School of Medicine