Comparison of Cardiac Output Measurement by Noninvasive Method with Electrical Cardiometry and Invasive Method with Thermodilution Technique in Patients Undergoing Coronary Artery Bypass Grafting
Read full paper at:
http://www.scirp.org/journal/PaperInformation.aspx?PaperID=47929#.VFbpo2fHRK0
http://www.scirp.org/journal/PaperInformation.aspx?PaperID=47929#.VFbpo2fHRK0
Author(s)
Objective: This study was conducted to compare the cardiac output by
using Electrical Cardiometry (EC), a noninvasive method of continuous
cardiac output monitoring during cardiac surgery with pulmonary artery
catheter (PAC) derived cardiac output. Design: Prospective observational
clinical study. Setting: Cardiac surgery operating room of a tertiary
care cardiac center. Participants: Twenty five patients undergoing
coronary artery bypass surgery with cardiopulmonary bypass. Measurements
and Main Results: A total of 150 double data of cardiac output were
compared with Thermodilution Cardiac Output (TDCO) and Thoracic
Electrical Bioimpedance (TEBCO). The TDCO value ranges from 1.8-6.9
litre·min-1 with a mean of 4.39 ± 1.16 litre·min-1 and TEBCO ranges from 1.8-7.1 litre·min-1 with a mean of 4.21 ± 1.16 litre·min-1.
The averaged Bland-Altman analysis for TDCO and TEBCO revealed that a
mean bias was 0.18 and limit of agreement was -1.25 - 0.89 litre·min-1
and the percentage error (PE) ranged from 22%-32%. The precision for
the TDCO was measured to be ±16.2% and the precision for TEBCO was
±19.6%. Receiver Operating Characteristic (ROC) curve analysis between
TDCO and TEBCO with a cutoff of 15% shows a sensitivity of 84% and
specificity of 63 and area under ROC curve of 0.80. Mountain plot
between TDCO and TEBCO shows that a median percentile is 0.25 and value
of 97.5 percentile is 1.525. Conclusions: The present study indicates
that the electric cardiometry device yields numerically comparable
results to cardiac outputs derived from the PAC during the cardiac
surgery. Therefore, electrical cardiometry can be used to evaluate
haemodynamic variables with clinically acceptable accuracy, when
invasive methods are to be avoided or not available.
KEYWORDS
Cite this paper
Rajput, R. , Das, S. , Chauhan, S. , Bisoi, A. and
Vasdev, S. (2014) Comparison of Cardiac Output Measurement by
Noninvasive Method with Electrical Cardiometry and Invasive Method with
Thermodilution Technique in Patients Undergoing Coronary Artery Bypass
Grafting. World Journal of Cardiovascular Surgery, 4, 123-130. doi: 10.4236/wjcs.2014.47019.
| [1] |
Dellinger, R.P., Carlet, J.M.,
Masur, H., et al. (2004) Surviving Sepsis Campaign Management Guidelines
Committee. Surviving Sepsis Campaign Guidelines for Management of
Severe Sepsis and Septic Shock. Critical Care Medicine, 32, 858-873. http://dx.doi.org/10.1097/01.CCM.0000117317.18092.E4 |
| [2] |
Shoemaker, W.C., Wo, C.C., Chan,
L., et al. (2001) Outcome Prediction of Emergency Patients by
Noninvasive Haemodynamic Monitoring. Chest, 120, 528-537. http://dx.doi.org/10.1378/chest.120.2.528 |
| [3] |
Swan, H.J.C., Ganz, W.,
Forrester, J., et al. (1970) Catheterization of the Heart in Man with
Use of a Flow-Directed Balloon-Tipped Catheter. The New England Journal
of Medicine, 283, 447-451. http://dx.doi.org/10.1056/NEJM197008272830902 |
| [4] | De Waal, E.E.C., De Rossi, L. and Buhre, W. (2006) Pulmonary Artery Catheter in Anaesthesiology and Intensive Care. Anaesthesist, 55, 713-730. |
| [5] |
Connors Jr., A.F., Castele,
R.J., Farhat, N.Z., et al. (1985) Complications of Right Heart
Catheterization. A Prospective Autopsy Study. Chest, 88, 567-572. http://dx.doi.org/10.1378/chest.88.4.567 |
| [6] |
Peters, S.G., Afessa, B.,
Decker, P.A., et al. (2003) Increased Risk Associated with Pulmonary
Artery Catheterization in the Medical Intensive Care Unit. Journal of
Critical Care, 18, 166-171. http://dx.doi.org/10.1016/j.jcrc.2003.08.006 |
| [7] | Robin, E.D. (1987) Death by Pulmonary Artery Flow-Directed Catheter. Time for a Moratorium? Chest, 92, 727-731. http://dx.doi.org/10.1378/chest.92.4.727 |
| [8] |
Chaney, J.C. and Derdak, S.
(2002) Minimally Invasive Hemodynamic Monitoring for the Intensivist:
Current and Emerging Technology. Critical Care Medicine, 30, 2338-2345. http://dx.doi.org/10.1097/00003246-200210000-00025 |
| [9] | Bland, J.M. and Altman, D.G. (1986) Statistical Method for Assessing Agreement between two Methods of Clinical Measurements. Lancet, 8476, 307-310. http://dx.doi.org/10.1016/S0140-6736(86)90837-8 |
| [10] | Critchley, L.A. and Critchley, J.A. (1999) A Meta-Analysis of Studies Using Bias and Precision Statistics to Compare Cardiac Output Measurement Techniques. Journal of Clinical Monitoring and Computing, 15, 85-91. http://dx.doi.org/10.1023/A:1009982611386 |
| [11] | Cecconi, M., Rhodes, A., Poloniecki, J., et al. (2009) Bench-to-Bedside Review: The Importance of the Precision of the Reference Technique in Method Comparison Studies—With Specific Reference to the Measurement of Cardiac Output. Critical Care, 13, 201. http://dx.doi.org/10.1186/cc7129 |
| [12] | Cook, N.R. (2010) Methods of evaluating novel biomarkers—A New Paradigm. International Journal of Clinical Practice, 64, 1723-1727. http://dx.doi.org/10.1111/j.1742-1241.2010.02469.x |
| [13] | Krouwer, J.S. and Monti, K.L. (1995) A Simple, Graphical Method to Evaluate Laboratory Assays. European Journal of Clinical Chemistry and Biochemistry, 33, 525-527. |
| [14] | Mackenzie, J.D., Haites, N.E. and Rawles, J.M. (1986) Method of Assessing the Reproducibility of Blood Flow Measurement: Factors Influencing the Performance of Thermodilution Cardiac Output Computers. British Heart Journal, 55, 14-24. http://dx.doi.org/10.1136/hrt.55.1.14 |
| [15] | Stetz, C.W., Miller, R.G., Kelly, G.E. and Raffin, T.A. (1982) Reliability of the Thermodilution Method in the Determination of Cardiac Output in Clinical Practice. American Review of Respiratory Disease, 126, 1001-1004. |
| [16] |
Spiess, B.D., Patel, M.A.,
Soltow, L.O. and Wright, I.H. (2001) Comparison of Bioimpedance versus
Thermodilution Cardiac Output during Cardiac Surgery: Evaluation of a
Second-Generation Bioimpedance Device. Journal of Cardiothoracic and
Vascular Anesthesia, 15, 567-573. http://dx.doi.org/10.1053/jcan.2001.26533 |
| [17] | Sageman, W.S., Riffenburg, R.H. and Spiess, B.D. (2002) Equivalance of Bioimpedeceand Thermodilution in Measuring Cardiac Index after Cardiac Surgery. Journal of Cardiothoracic and Vascular Anesthesia, 16, 8-14. http://dx.doi.org/10.1053/jcan.2002.29635 |
| [18] | Gujjar, A.R., Muralidhar, K., Banakal, S., Gupta, R., Sathyaprabha, T.N. and Jairaj, P.S. (2008) Non Invasive Cardiac Output by Trans Thoracic Electrical Bioimpedance in Post Cardiac Surgery Patients: Comparison with Thermodilution Method. Journal of Clinical Monitoring and Computing, 22, 175-180. http://dx.doi.org/10.1007/s10877-008-9119-y |
| [19] | Suttner, S., Schollhorn, T., Boldt, J., Mayer, J., Rohm, K.D., Lang, K., et al. (2006) Non Invasive Assessment of Cardiac Output Using Trans Thoracicelectrical Bioimpedance in Hemodynamically Stable and Unstable Patients after Cardiac Surgery: A Comparison with Pulmonary Artery Dilution. Intensive Care Medicine, 32, 2053-2058. http://dx.doi.org/10.1007/s00134-006-0409-x |
| [20] |
Chakravarthy, M., Rajeev, S. and
Jawali, V. (2009) Cardiac Index Measurement by Invasive, Semi Invasive
and Non Invasive Techniques: A Prospective Studying Postoperative Off
Pump Coronary Artery Bypass Surgery Patients. Journal of Clinical
Monitoring and Computing, 23, 175-180. http://dx.doi.org/10.1007/s10877-009-9179-7 |
| [21] | Sharma, V., Singh, A., Kansara, B. and Karlekar, A. (2011) Comparison of Transthoracic Electrical Bioimpedance Cardiac Output Measurement with Thrmodilution Method in Post Coronary Artery Bypass Graft Patients. Annals of Cardiac Anaesthesia, 14, 104-110. |
| [22] | Marik, P.E., Pendelton, J.E. and Smith, R. (1997) A Comparison of Hemodynamic Parameters Derived from Transthoracic Electrical Bioimpedance with Those Parameters Obtained by Thermodilution and Ventricular Angiography. Critical Care Medicine, 25, 1545-1550. http://dx.doi.org/10.1097/00003246-199709000-00023 |
| [23] | Wang, D.J. and Gottlieb, S.S. (2006) Impedance Cardiography: More Questions than Answers. Current Cardiology Reports, 8, 180-186. http://dx.doi.org/10.1007/s11886-006-0031-0 |
| [24] | Sathyaprabha, T.N., Pradhan, C., Rashmi, G., Thennarasu, K. and Raju, T.R. (2008) Noninvasive Cardiac Output Measurement by Transthoracic Electrical Bioimpedence: Influence of Age and Gender. Journal of Clinical Monitoring and Computing, 22, 401-408. http://dx.doi.org/10.1007/s10877-008-9148-6 |
| [25] | Imai, M., Hanaoka, Y. and Kemmotsu, O. (1994) Valve Injury: A New Complication of Internal Jugular Vein Cannulation. Anesthesia & Analgesia, 78, 1041-1046. |
| [26] | Heath, K.J., Woulfe, J., Lownie, S., et al. (1998) A Devastating Complication of Inadvertent Carotid Artery Puncture. Anesthesiology, 89, 1273-1275. http://dx.doi.org/10.1097/00000542-199811000-00035 |
| [27] | Muralidhar, K. (1998) Complication of Femoral Artery Pressure Monitoring. Journal of Cardiothoracic and Vascular Anesthesia, 12, 128-129. http://dx.doi.org/10.1016/S1053-0770(98)90086-6 eww141103lx |
评论
发表评论