Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2017 Jul-Sep;7(3):156-162.
doi: 10.4103/2229-5151.214411.

Comparison of pulmonary artery catheter, echocardiography, and arterial waveform analysis monitoring in predicting the hemodynamic state during and after cardiac surgery

Paul Power  1 , Allison Bone  1 , Nicholas Simpson  1   2 , Cheng-Hon Yap  3   4 , Simon Gower  5 , Michael Bailey  6
Affiliations

Comparison of pulmonary artery catheter, echocardiography, and arterial waveform analysis monitoring in predicting the hemodynamic state during and after cardiac surgery

Paul Power et al. Int J Crit Illn Inj Sci. 2017 Jul-Sep.

Abstract

Objective: The aim of this trial was to determine whether Flotrac Vigileo™ (FV™) provides a reliable representation of the hemodynamic state of a cardiac surgical patient population when compared to pulmonary artery catheter (PAC) and echocardiography in the peril-operative period.

Design: This was a prospective observational trial comparing perioperative hemodynamic states using transesophageal echocardiography (TEE), transthoracic echocardiography (TTE), FV™ and PAC during and post cardiothoracic surgery.

Setting: Tertiary regional hospital Intensive Care Unit (ICU).

Participants: 50 consecutive adult cardiothoracic patients with written consent provided.

Intervention: Comparison of the perioperative hemodynamic states using echocardiography, FV™ and PAC was performed. Evaluation of the hemodynamic state (HDS) was performed using TEE, TTE, PAC and FV™ during and after cardiac surgery. Data were compared between the three hemodynamic assessment modalities.

Main outcome measure: Predicted hemodynamic state.

Results: FV™ and PAC were shown to correlate poorly with TEE/TTE assessment of the hemodynamic state. Both PAC and FV™ showed significant discordance with echocardiographic assessment of the hemodynamic state.

Conclusions: In this trial, FV™ and PAC were shown to agree poorly with TTE/TEE assessment of the HDS in an adult cardiothoracic population. Agreement between the FV™ and PAC was also poor. Caution is recommended in interpreting isolated hemodynamic monitoring data. All hemodynamic monitoring devices have inherent sources of error. Caution is advised in interpreting any single device or measurement as a gold standard. We suggest that hemodynamic measuring devices such as FV™/PAC may act as triggers for a global hemodynamic assessment including consideration of TTE/TEE.

Keywords: Anesthesia; cardiaothoracic; hemodynamic monitoring; intensive care.

PubMed Disclaimer

Conflict of interest statement

There are no conflicts of interest.

References

    1. Richard C, Monnet X, Teboul JL. Pulmonary artery catheter monitoring in 2011. Curr Opin Crit Care. 2011;17:296–302. - PubMed
    1. Koo KK, Sun JC, Zhou Q, Guyatt G, Cook DJ, Walter SD, et al. Pulmonary artery catheters: Evolving rates and reasons for use. Crit Care Med. 2011;39:1613–8. - PubMed
    1. Harvey S, Harrison DA, Singer M, Ashcroft J, Jones CM, Elbourne D, et al. Assessment of the clinical effectiveness of pulmonary artery catheters in management of patients in intensive care (PAC-Man): A randomised controlled trial. Lancet. 2005;366:472–7. - PubMed
    1. Abreu AR, Campos MA, Krieger BP. Pulmonary artery rupture induced by a pulmonary artery catheter: A case report and review of the literature. J Intensive Care Med. 2004;19:291–6. - PubMed
    1. Argueta E, Berdine G, Pena C, Nugent KM. FloTrac® monitoring system: What are its uses in critically ill medical patients? Am J Med Sci. 2015;349:352–6. - PubMed