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Comparative Study
. 2009;13(2):R32.
doi: 10.1186/cc7739. Epub 2009 Mar 4.

Assessment of cardiac output changes using a modified FloTrac/Vigileo algorithm in cardiac surgery patients

Alban Senn  1 , Danny Button, Andreas Zollinger, Christoph K Hofer
Affiliations
Comparative Study

Assessment of cardiac output changes using a modified FloTrac/Vigileo algorithm in cardiac surgery patients

Alban Senn et al. Crit Care. 2009.

Abstract

Introduction: The FloTrac/Vigileo (Edwards Lifesciences, Irvine, CA, USA) allows pulse pressure-derived cardiac output measurement without external calibration. Software modifications were performed in order to eliminate initially observed deficits. The aim of this study was to assess changes in cardiac output determined by the FloTrac/Vigileo system (FCO) with an initially released (FCOA) and a modified (FCOB) software version, as well as changes in cardiac output from the PiCCOplus system (PCO; Pulsion Medical Systems, Munich, Germany). Both devices were compared with cardiac output measured by intermittent thermodilution (ICO).

Methods: Cardiac output measurements were performed in patients after elective cardiac surgery. Two sets of data (A and B) were obtained using FCOA and FCOB in 50 patients. After calibration of the PiCCOplus system, triplicate FCO and PCO values were recorded and ICO was determined in the supine position and cardiac output changes due to body positioning were recorded 15 minutes later (30 degrees head-up, 30 degrees head-down, supine). Student's t test, analysis of variance and Bland-Altman analysis were calculated.

Results: Significant changes of FCO, PCO and ICO induced by body positioning were observed in both data sets. For set A, DeltaFCOA was significantly larger than DeltaICO induced by positioning the head down. For set B, there were no significant differences between DeltaFCOB and DeltaICO. For set A, increased limits of agreement were found for FCOA-ICO when compared with PCO-ICO. For set B, mean bias and limits of agreement were comparable for FCOB-ICO and PCO-ICO.

Conclusions: The modification of the FloTrac/Vigileo system resulted in an improved performance in order to reliably assess cardiac output and track the related changes in patients after cardiac surgery.

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Figures

Figure 1
Figure 1
Study protocol. Set A was FCO assessed using the software version 1.03, and set B was FCO assessed using the software version 1.07. FCO = cardiac output assessed by the FloTrac/Vigileo™ device; ICO = cardiac output determined by the intermittent thermodilution; PCO = cardiac output assessed by the PiCCOplus™ system.
Figure 2
Figure 2
Cardiac output changes assessed during the study period. Set A was FCO assessed using the software version 1.03, and set B was FCO assessed using the software version 1.07. FCO = cardiac output assessed by the FloTrac/Vigileo™ device; ICO = cardiac output determined by the intermittent thermodilution; PCO = cardiac output assessed by the PiCCOplus™ system.
Figure 3
Figure 3
Bland-Altman analysis for set A: comparison of the FloTrac/Vigileo™ system and intermittent thermodilution. Solid line = mean bias; dashed lines = limits of agreement. FCOA = cardiac output assessed by the FloTrac/Vigileo™ system using the software version 1.03; ICO = cardiac output determined by the intermittent thermodilution; PCO = cardiac output assessed by the PiCCOplus™ system.
Figure 4
Figure 4
Bland-Altman analysis for set B: comparison of the PiCCOplus™ system and intermittent thermodilution. Solid line = mean bias; dashed lines = limits of agreement. FCOB = cardiac output assessed by the FloTrac/Vigileo™ system using the software version 1.07; ICO = cardiac output determined by the intermittent thermodilution; PCO = cardiac output assessed by the PiCCOplus™ system.
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Comment in

References

    1. Connors AF, Jr, Speroff T, Dawson NV, Thomas C, Harrell FE, Jr, Wagner D, Desbiens N, Goldman L, Wu AW, Califf RM, Fulkerson WJ, Jr, Vidaillet H, Broste S, Bellamy P, Lynn J, Knaus WA. The effectiveness of right heart catheterization in the initial care of critically ill patients. SUPPORT Investigators. JAMA. 1996;276:889–897. doi: 10.1001/jama.276.11.889. - DOI - PubMed
    1. Sandham JD, Hull RD, Brant RF, Knox L, Pineo GF, Doig CJ, Laporta DP, Viner S, Passerini L, Devitt H, Kirby A, Jacka M. A randomized, controlled trial of the use of pulmonary-artery catheters in high-risk surgical patients. N Engl J Med. 2003;348:5–14. doi: 10.1056/NEJMoa021108. - DOI - PubMed
    1. Takala J. The pulmonary artery catheter: the tool versus treatments based on the tool. Crit Care. 2006;10:162. doi: 10.1186/cc5021. - DOI - PMC - PubMed
    1. Hofer CK, Ganter MT, Zollinger A. What technique should I use to measure cardiac output? Curr Opin Crit Care. 2007;13:308–317. doi: 10.1097/MCC.0b013e3280c56afb. - DOI - PubMed
    1. Della Rocca G, Costa MG, Coccia C, Pompei L, Di Marco P, Vilardi V, Pietropaoli P. Cardiac output monitoring: aortic transpulmonary thermodilution and pulse contour analysis agree with standard thermodilution methods in patients undergoing lung transplantation. Can J Anaesth. 2003;50:707–711. - PubMed

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