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Khanna AK, Garcia JO, Saha AK, Harris L, Baruch M, Martin RS. Agreement between cardiac output estimation with a wireless, wearable pulse decomposition analysis device and continuous thermodilution in post cardiac surgery intensive care unit patients. J Clin Monit Comput 2024; 38:139-146. [PMID: 37458916 DOI: 10.1007/s10877-023-01059-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/09/2023] [Accepted: 07/07/2023] [Indexed: 02/21/2024]
Abstract
PURPOSE Pulse Decomposition Analysis (PDA) uses integration of the systolic area of a distally transmitted aortic pulse as well as arterial stiffness estimates to compute cardiac output. We sought to assess agreement of cardiac output (CO) estimation between continuous pulmonary artery catheter (PAC) guided thermodilution (CO-CCO) and a wireless, wearable noninvasive device, (Vitalstream, Caretaker Medical, Charlottesville, VA), that utilizes the Pulse Decomposition Analysis (CO-PDA) method in postoperative cardiac surgery patients in the intensive care unit. METHODS CO-CCO measurements were compared with post processed CO-PDA measurements in prospectively enrolled adult cardiac surgical intensive care unit patients. Uncalibrated CO-PDA values were compared for accuracy with CO-CCO via a Bland-Altman analysis considering repeated measurements and a concordance analysis with a 10% exclusion zone. RESULTS 259.7 h of monitoring data from 41 patients matching 15,583 data points were analyzed. Mean CO-CCO was 5.55 L/min, while mean values for the CO-PDA were 5.73 L/min (mean of differences +- SD 0.79 ± 1.11 L/min; limits of agreement - 1.43 to 3.01 L/min), with a percentage error of 37.5%. CO-CCO correlation with CO-PDA was moderate (0.54) and concordance was 0.83. CONCLUSION Compared with the CO-CCO Swan-Ganz, cardiac output measurements obtained using the CO-PDA were not interchangeable when using a 30% threshold. These preliminary results were within the 45% limits for minimally invasive devices, and pending further robust trials, the CO-PDA offers a noninvasive, wireless solution to complement and extend hemodynamic monitoring within and outside the ICU.
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Affiliation(s)
- Ashish K Khanna
- Department of Anesthesiology, Section on Critical Care Medicine, School of Medicine, Wake Forest University, Atrium Health Wake Forest Baptist Medical Center, Winston-Salem, NC, USA.
- Outcomes Research Consortium, Cleveland, OH, USA.
- Perioperative Outcomes and Informatics Collaborative (POIC), Winston-Salem, NC, USA.
| | - Julio O Garcia
- Wake Forest University School of Medicine, Winston-Salem, NC, USA
| | - Amit K Saha
- Perioperative Outcomes and Informatics Collaborative (POIC), Winston-Salem, NC, USA
- Department of Anesthesiology, Wake Forest University School of Medicine, Atrium Health Wake Forest Baptist Medical Center, Winston-Salem, NC, USA
| | - Lynnette Harris
- Perioperative Outcomes and Informatics Collaborative (POIC), Winston-Salem, NC, USA
- Department of Anesthesiology, Wake Forest University School of Medicine, Atrium Health Wake Forest Baptist Medical Center, Winston-Salem, NC, USA
| | | | - R Shayn Martin
- Department of Surgery, Wake Forest University School of Medicine, Atrium Health Wake Forest Baptist Medical Center, Winston-Salem, NC, USA
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Harford M, Villarroel M, Jorge J, Redfern O, Finnegan E, Davidson S, Young JD, Tarassenko L, Watkinson P. Contactless skin perfusion monitoring with video cameras: tracking pharmacological vasoconstriction and vasodilation using photoplethysmographic changes. Physiol Meas 2022; 43. [PMID: 36270506 DOI: 10.1088/1361-6579/ac9c82] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2022] [Accepted: 10/21/2022] [Indexed: 02/07/2023]
Abstract
Objectives.Clinical assessment of skin perfusion informs prognosis in critically ill patients. Video camera monitoring could provide an objective, continuous method to monitor skin perfusion. In this prospective, interventional study of healthy volunteers, we tested whether video camera-derived photoplethysmography imaging and colour measurements could detect drug-induced skin perfusion changes.Approach.We monitored the lower limbs of 30 volunteers using video cameras while administering phenylephrine (a vasoconstrictor) and glyceryl trinitrate (a vasodilator). We report relative pixel intensity changes from baseline, as absolute values are sensitive to environmental factors. The primary outcome was the pre- to peak- infusion green channel amplitude change in the pulsatile PPGi waveform component. Secondary outcomes were pre-to-peak changes in the photoplethysmographic imaging waveform baseline, skin colour hue and skin colour saturation.Main results.The 30 participants had a median age of 29 years (IQR 25-34), sixteen (53%) were male. A 34.7% (p= 0.0001) mean decrease in the amplitude of the pulsatile photoplethysmographic imaging waveform occurred following phenylephrine infusion. A 30.7% (p= 0.000004) mean increase occurred following glyceryl trinitrate infusion. The photoplethysmographic imaging baseline decreased with phenylephrine by 2.1% (p= 0.000 02) and increased with glyceryl trinitrate by 0.5% (p= 0.026). Skin colour hue changed in opposite direction with phenylephrine (-0.0013,p= 0.0002) and glyceryl trinitrate (+0.0006,p= 0.019). Skin colour saturation decreased with phenylephrine by 0.0022 (p= 0.0002), with no significant change observed with glyceryl trinitrate (+0.0005,p= 0.21).Significance.Drug-induced vasoconstriction and vasodilation are associated with detectable changes in photoplethysmographic imaging waveform parameters and skin hue. Our findings suggest video cameras have great potential for continuous, contactless skin perfusion monitoring.
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Affiliation(s)
- M Harford
- Critical Care Research Group, Kadoorie Centre for Critical Care Research and Education, Nuffield Department of Clinical Neurosciences, University of Oxford, United Kingdom.,Institute of Biomedical Engineering, Department of Engineering Science, University of Oxford, United Kingdom.,Oxford University Hospitals NHS Foundation Trust, Oxford, United Kingdom
| | - M Villarroel
- Institute of Biomedical Engineering, Department of Engineering Science, University of Oxford, United Kingdom
| | - J Jorge
- Institute of Biomedical Engineering, Department of Engineering Science, University of Oxford, United Kingdom
| | - O Redfern
- Critical Care Research Group, Kadoorie Centre for Critical Care Research and Education, Nuffield Department of Clinical Neurosciences, University of Oxford, United Kingdom
| | - E Finnegan
- Institute of Biomedical Engineering, Department of Engineering Science, University of Oxford, United Kingdom
| | - S Davidson
- Institute of Biomedical Engineering, Department of Engineering Science, University of Oxford, United Kingdom
| | - J D Young
- Critical Care Research Group, Kadoorie Centre for Critical Care Research and Education, Nuffield Department of Clinical Neurosciences, University of Oxford, United Kingdom
| | - L Tarassenko
- Institute of Biomedical Engineering, Department of Engineering Science, University of Oxford, United Kingdom
| | - P Watkinson
- Critical Care Research Group, Kadoorie Centre for Critical Care Research and Education, Nuffield Department of Clinical Neurosciences, University of Oxford, United Kingdom.,Oxford University Hospitals NHS Foundation Trust, Oxford, United Kingdom
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Liu Z, Zhou C, Wang H, He Y. Blood pressure monitoring techniques in the natural state of multi-scenes: A review. Front Med (Lausanne) 2022; 9:851172. [PMID: 36091712 PMCID: PMC9462511 DOI: 10.3389/fmed.2022.851172] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/09/2022] [Accepted: 08/11/2022] [Indexed: 11/17/2022] Open
Abstract
Blood pressure is one of the basic physiological parameters of human physiology. Frequent and repeated measurement of blood pressure along with recording of environmental or other physiological parameters when measuring blood pressure may reveal important cardiovascular risk factors that can predict occurrence of cardiovascular events. Currently, wearable non-invasive blood pressure measurement technology has attracted much research attention. Several different technical routes have been proposed to solve the challenge between portability or continuity of measurement methods and medical level accuracy of measurement results. The accuracy of blood pressure measurement technology based on auscultation and oscillography has been clinically verified, while majority of other technical routes are being explored at laboratory or multi-center clinical demonstration stage. Normally, Blood pressure measurement based on oscillographic method outside the hospital can only be measured at intervals. There is a need to develop techniques for frequent and high-precision blood pressure measurement under natural conditions outside the hospital. In this paper, we discussed the current status of blood pressure measurement technology and development trends of blood pressure measurement technology in different scenarios. We focuses on the key technical challenges and the latest advances in the study of miniaturization devices based on oscillographic method at wrist and PTT related method at finger positions as well as technology processes. This study is of great significance to the application of high frequency blood pressure measurement technology.
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Affiliation(s)
- Ziyi Liu
- College of Biosystems Engineering and Food Science, Zhejiang University, Hangzhou, China
- Guangdong Transtek Medical Electronics Co., Ltd., Zhongshan, China
| | - Congcong Zhou
- Sir Run Run Shaw Hospital, School of Medicine, Zhejiang University, Hangzhou, China
- Biosensor National Special Laboratory, College of Biomedical Engineering and Instrument Science, Zhejiang University, Hangzhou, China
| | - Hongwei Wang
- Tongde Hospital of Zhejiang Province, Hangzhou, China
- *Correspondence: Hongwei Wang,
| | - Yong He
- College of Biosystems Engineering and Food Science, Zhejiang University, Hangzhou, China
- Yong He,
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Qiu Y, Gu W, Zhao M, Zhang Y, Wu J. The hemodynamic stability of remimazolam compared with propofol in patients undergoing endoscopic submucosal dissection: A randomized trial. Front Med (Lausanne) 2022; 9:938940. [PMID: 36004376 PMCID: PMC9394743 DOI: 10.3389/fmed.2022.938940] [Citation(s) in RCA: 18] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/08/2022] [Accepted: 07/12/2022] [Indexed: 11/13/2022] Open
Abstract
ObjectiveHypotension is common in propofol anesthesia. Whether remimazolam could reduce intraoperative hypotension remains unknown. We therefore tested the primary hypothesis that remimazolam reduces the incidence of intraoperative hypotension compared with propofol in adult patients undergoing endoscopic submucosal dissection (ESD) surgery.Materials and methodsWe conducted a prospective trial to compare patients who received either remimazolam or propofol bolus induction and thereafter intravenous infusion. The hemodynamic parameters were measured using CNAP® Monitor 500 system. Our primary analysis was to compare the incidence of hypotension defined as systolic blood pressure below 90 mmHg between remimazolam and propofol during the whole anesthesia period.ResultsThe incidence of hypotension decreased by 50%, from 67.9% in propofol group to 32.1% in remimazolam group (p < 0.01). Patients received less amount of intraoperative phenylephrine in the remimazolam group than the propofol group (0 [0–40] μg vs. 80 [0–200] μg, p < 0.01). Time-weighted average and cumulative time of hypotension was lower in remimazolam group compared with propofol group (p < 0.05). Cardiac output continuously measured by CNAP was preserved much better in remimazolam group compared with propofol group (p = 0.01), while systemic vascular resistance did not differ between the groups. The median time from discontinuation until full alertness was 4 [3–11.8] min in the remimazolam group compared with 15 [12.0–19.8] min in the propofol group (p < 0.01).ConclusionRemimazolam has better hemodynamic stability than propofol in adult patients undergoing ESD surgery. The benefits of remimazolam on hemodynamic stability and hypotension prevention may be partly contributed to its better preservation of cardiac output.Clinical Trial Registration[http://www.chictr.org.cn/com/25/showproj.aspx?proj=61104], identifier [ChiCTR2000037975].
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Affiliation(s)
- Yuwei Qiu
- Department of Anesthesiology, Shanghai Chest Hospital, Shanghai Jiao Tong University, Shanghai, China
- Outcomes Research Consortium, Cleveland, OH, United States
| | - Wei Gu
- Department of Anesthesiology, Shanghai Chest Hospital, Shanghai Jiao Tong University, Shanghai, China
| | - Mingye Zhao
- Department of Anesthesiology, Shanghai Chest Hospital, Shanghai Jiao Tong University, Shanghai, China
| | - Yunyun Zhang
- Department of Anesthesiology, Shanghai Chest Hospital, Shanghai Jiao Tong University, Shanghai, China
| | - Jingxiang Wu
- Department of Anesthesiology, Shanghai Chest Hospital, Shanghai Jiao Tong University, Shanghai, China
- Outcomes Research Consortium, Cleveland, OH, United States
- *Correspondence: Jingxiang Wu,
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Bobet M, Joachim J, Gayat E, Bonnet A, Sievert K, Barnichon C, Fischler M, Le Guen M. Blood pressure measurement during cesarean delivery: Evaluation of a beat-to-beat noninvasive device (NexfinTM). Medicine (Baltimore) 2021; 100:e26129. [PMID: 34087863 PMCID: PMC8183779 DOI: 10.1097/md.0000000000026129] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/31/2020] [Accepted: 05/06/2021] [Indexed: 01/04/2023] Open
Abstract
Early detection of arterial hypotension during cesarean delivery under spinal anesthesia is important. This study aims to compare the validity of NexfinTM as beat-to-beat noninvasive blood pressure monitoring with conventional intermittent oscillometric measurement of blood pressure during elective cesarean delivery.This open prospective observational bicentric study was performed between January 2013 and December 2015. We simultaneously recorded arterial blood pressure with both techniques in pregnant women undergoing elective cesarean delivery under spinal anesthesia. The primary outcome was a Bland-Altman analysis of systolic blood pressure measurement comparing NexfinTM and a conventional method. The secondary outcomes were the time to detect the first relevant hypotensive episode and the comparison of both devices using a four-quadrant graph.One hundred and seventy-four parturients completed the study, and 2640 pairs of systolic blood pressure measurements were analyzed. Bias was -10 mmHg with upper and lower limits of agreement of -61 and +41 mmHg. In 73.9% of the cases, the two techniques provided the same information (normotension or hypotension), but the conventional method missed 20.8% of measurements, with NexfinTM detecting 16.2% more hypotensive measurements. The median [25-75 percentiles] duration to detect the first hypotensive measurement was 331 [206-480] seconds for NexfinTM and 440 [300-500] s for intermittent oscillometry (P < .001).The agreement between NexfinTM and an intermittent method for the measurement of systolic blood pressure was not in an acceptable range during cesarean delivery, although NexfinTM may detect hypotension earlier than the standard method.Trial registration: Clinicaltrials.gov identifier: NCT01732133; November 22, 2012.
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Affiliation(s)
- Mathieu Bobet
- Department of Anesthesiology, Hôpital Foch, Suresnes, France and University Versailles Saint-Quentin en Yvelines, Montigny-Le-Bretonneux
| | - Jona Joachim
- Department of Anesthesiology and Intensive Care, Hôpital Lariboisière - Saint Louis, Paris, France and Inserm, UMRS-942 and Paris Diderot University, Paris
| | - Etienne Gayat
- Department of Anesthesiology and Intensive Care, Hôpital Lariboisière - Saint Louis, Paris, France and Inserm, UMRS-942 and Paris Diderot University, Paris
| | - Agnès Bonnet
- Department of Anesthesiology, Institut Hospitalier Franco-Britannique, Levallois-Perret, France
| | - Kerstin Sievert
- Department of Anesthesiology, Hôpital Foch, Suresnes, France and University Versailles Saint-Quentin en Yvelines, Montigny-Le-Bretonneux
| | - Carole Barnichon
- Department of Anesthesiology, Institut Hospitalier Franco-Britannique, Levallois-Perret, France
| | - Marc Fischler
- Department of Anesthesiology, Hôpital Foch, Suresnes, France and University Versailles Saint-Quentin en Yvelines, Montigny-Le-Bretonneux
| | - Morgan Le Guen
- Department of Anesthesiology, Hôpital Foch, Suresnes, France and University Versailles Saint-Quentin en Yvelines, Montigny-Le-Bretonneux
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Lu SY, Dalia AA. Continuous Noninvasive Arterial Pressure Monitoring for Transcatheter Aortic Valve Replacement. J Cardiothorac Vasc Anesth 2021; 35:2026-2033. [PMID: 33549488 DOI: 10.1053/j.jvca.2021.01.012] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/08/2020] [Revised: 01/04/2021] [Accepted: 01/06/2021] [Indexed: 11/11/2022]
Abstract
OBJECTIVES The objective of the present study, which was conducted in patients undergoing transcatheter aortic valve replacement, was to compare continuous noninvasive arterial pressure measured with the ClearSight device (Edwards Lifesciences, Irvine, CA) with invasive radial artery pressure used as the reference method. The authors hypothesized that the ClearSight device is an accurate, precise, safe, and efficient method for arterial blood pressure measurement comparable with an invasive radial arterial line. DESIGN The study included the retrospective review of 20 consecutive patients scheduled for elective transcatheter aortic valve replacement with the SAPIEN 3 transcatheter heart valve (Edwards Lifesciences) at a single tertiary academic hospital, who underwent monitoring with both the ClearSight device and an invasive radial arterial pressure line. The patients underwent transcatheter aortic valve replacement from October to December 2019. SETTING Single tertiary academic medical center. PARTICIPANTS The study comprised 20 patients, with 2,243 unique blood pressure data points. INTERVENTIONS None. MEASUREMENTS AND MAIN RESULTS A statistically significant correlation between the invasive radial arterial pressure line and the ClearSight device was observed for systolic blood pressure (correlation coefficient 0.86; p < 0.001), diastolic blood pressure (correlation coefficient 0.56; p < 0.001), and mean arterial pressure (correlation coefficient 0.78; p < 0.001). Bland-Altman analysis was used to assess the agreement of systolic blood pressure, diastolic blood pressure, and mean arterial pressure between the two methods. Results for systolic blood pressure between the arterial line and ClearSight device were as follows: bias = 9.8 ± 10.1, percentage bias = 7.6%, and mean error = 15.8%. Results for diastolic blood pressure between the arterial line and ClearSight device were as follows: bias = -5.9 ± 7.8, percentage bias = 10.7%, and mean error = 28.4%. Results for mean arterial pressure between the arterial line and ClearSight device were as follows: bias = 0.3 ± 7.4, percentage bias = 0.4%, and mean error = 18.3%. The concordance rates of systolic blood pressure, diastolic blood pressure, and mean arterial pressure were 100%, 95.1%, and 98.8%, respectively. CONCLUSIONS The accuracy, agreement, and precision of the ClearSight device were convincing for mean arterial pressure, systolic blood pressure, and diastolic blood pressure for patients with severe aortic stenosis undergoing elective transcatheter aortic valve replacement.
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Affiliation(s)
- Shu Y Lu
- Department of Anesthesiology, Pain Medicine, and Critical Care Medicine, Massachusetts General Hospital, Harvard Medical School, Boston, MA; Department of Critical Care Medicine, Massachusetts General Hospital Heart Center, Massachusetts General Hospital, Harvard Medical School, Boston, MA
| | - Adam A Dalia
- Department of Anesthesiology, Pain Medicine, and Critical Care Medicine, Massachusetts General Hospital, Harvard Medical School, Boston, MA.
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Non-invasive continuous blood pressure monitoring (ClearSight™ system) during shoulder surgery in the beach chair position: a prospective self-controlled study. BMC Anesthesiol 2020; 20:271. [PMID: 33099306 PMCID: PMC7585229 DOI: 10.1186/s12871-020-01185-6] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/26/2020] [Accepted: 10/13/2020] [Indexed: 02/02/2023] Open
Abstract
Background The beach chair position that is commonly used in shoulder surgery is associated with relative hypovolemia, which leads to a reduction in arterial blood pressure. The effects of patient positioning on the accuracy of non-invasive continuous blood pressure monitoring with the ClearSight™ system (CS-BP; Edwards Lifesciences, Irvine CA, USA) have not been studied extensively. Our research aim was to assess agreement levels between CS-BP measurements with traditional blood pressure monitoring techniques. Methods For this prospective self-controlled study, we included 20 consecutively treated adult patients undergoing elective shoulder surgery in the beach chair position. We performed Bland-Altman analyses to determine agreement levels between blood pressure values from CS-BP and standard non-invasive (NIBP) methods. Perioperative measurements were done in both the supine (as reference) and beach chair surgical positions. Additionally, we compared invasive blood pressure (IBP) measurements with both the non-invasive methods (CS-BP and NIBP) in a sub-group of patients (n = 10) who required arterial blood pressure monitoring. Results We analyzed 229 data points (116 supine, 113 beach chair) from the entire cohort; per patient measurements were based on surgical length (range 3–9 supine, 2–10 beach chair). The mean difference (±SD; 95% limits of agreement) in the mean arterial pressure (MAP) between CS-BP and NIBP was − 0.9 (±11.0; − 24.0–22.2) in the beach chair position and − 4.9 mmHg (±11.8; − 28.0–18.2) when supine. In the sub-group, the difference between CS-BP and IBP in the beach chair position was − 1.6 mmHg (±16.0; − 32.9–29.7) and − 2.8 mmHg (±15.3; − 32.8–27.1) in the supine position. Between NIBP and IBP, we detected a difference of 3.0 mmHg (±9.1; − 20.8–14.7) in the beach chair position, and 4.6 mmHg (±13.3; − 21.4–30.6) in the supine position. Conclusions We found clinically acceptable mean differences in MAP measurements between the ClearSight™ and non-invasive oscillometric blood pressure systems when patients were in either the supine or beach chair position. For all comparisons of the monitoring systems and surgical positions, the standard deviations and limits of agreement were wide. Trial registration This study was prospectively registered at the German Clinical Trial Register (www.DRKS.de; DRKS00013773). Registered 26/01/2018.
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Heijne A, Krijtenburg P, Bremers A, Scheffer GJ, Malagon I, Slagt C. Four different methods of measuring cardiac index during cytoreductive surgery and hyperthermic intraperitoneal chemotherapy. Korean J Anesthesiol 2020; 74:120-133. [PMID: 32819047 PMCID: PMC8024204 DOI: 10.4097/kja.20202] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2020] [Accepted: 08/14/2020] [Indexed: 01/21/2023] Open
Abstract
Background Cytoreductive surgery (CRS) and hyperthermic intraperitoneal chemotherapy (HIPEC) are high-risk extensive abdominal surgery. During high-risk surgery, less invasive methods for cardiac index (CI) measurement have been widely used in operating theater. We investigated the accuracy of CI derived from different methods (FroTrac, ProAQT, ClearSight, and arterial pressure waveform analysis [APWA], from PICCO) and compared them to transpulmonary thermodilution (TPTD) during CRS and HIPEC in the operative room and intensive care unit (ICU). Methods Twenty-five patients scheduled for CRS-HIPEC were enrolled. During nine predefined time-points, simultaneous hemodynamic measurements were performed in the operating room and ICU. Absolute and relative changes of CI were analyzed using a Bland-Altman plot, four-quadrant plot, and interchangeability. Results The mean bias was −0.1 L/min/m2 for ClearSight, ProAQT, and APWA and was −0.2 L/min/m2 for FloTrac compared with TPTD. All devices had large limits of agreement (LoA). The percentage of errors and interchangeabilities for ClearSight, FloTrac, ProAQT, and APWA were 50%, 50%, 54%, 36% and 36%, 47%, 40%, 72%, respectively. Trending capabilities expressed as concordance using clinically significant CI changes were −7º ± 39º, −19º ± 38º, −13º ± 41º, and −15º ± 39º. Interchangeability in trending showed low percentages of interchangeable and gray zone data pairs for all devices. Conclusions During CRS-HIPEC, ClearSight, FloTrac and ProAQT systems were not able to reliably measure CI compared to TPTD. Reproducibility of changes over time using concordance, angular bias, radial LoA, and interchangeability in trending of all devices was unsatisfactory.
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Affiliation(s)
- Amon Heijne
- Department of Anesthesiology, Pain and Palliative Medicine, Radboud University Medical Center, Nijmegen, The Netherlands
| | - Piet Krijtenburg
- Department of Anesthesiology, Pain and Palliative Medicine, Radboud University Medical Center, Nijmegen, The Netherlands
| | - Andre Bremers
- Department of Surgery, Radboud University Medical Center, Nijmegen, The Netherlands
| | - Gert Jan Scheffer
- Department of Anesthesiology, Pain and Palliative Medicine, Radboud University Medical Center, Nijmegen, The Netherlands
| | - Ignacio Malagon
- Department of Anesthesiology, Pain and Palliative Medicine, Radboud University Medical Center, Nijmegen, The Netherlands
| | - Cornelis Slagt
- Department of Anesthesiology, Pain and Palliative Medicine, Radboud University Medical Center, Nijmegen, The Netherlands
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Weitzel NS, Twite MD, Sakai T, Kertai MD. Advancing the Scientific and Educational Basis of Perioperative Cardiothoracic and Transplant Care. Semin Cardiothorac Vasc Anesth 2017; 21:273-276. [PMID: 29098956 DOI: 10.1177/1089253217738398] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
Affiliation(s)
| | - Mark D Twite
- 1 University of Colorado Anschutz Medical Campus, Aurora, CO, USA.,2 Children's Hospital Colorado and University of Colorado Anschutz Medical Campus, Aurora, CO, USA
| | - Tetsuro Sakai
- 3 University of Pittsburgh Medical Center, Pittsburgh, PA, USA
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