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. 2019;26(1):31-37.
doi: 10.6001/actamedica.v26i1.3953.

Comparison of two continuous non-invasive haemodynamic monitoring techniques in the perioperative setting

Jonė Jackevičiūtė  1 , Greta Kraujalytė  2 , Inna Jaremko  1 , Vilija Stremaitytė  1 , Jūratė Gudaitytė  1   2
Affiliations

Comparison of two continuous non-invasive haemodynamic monitoring techniques in the perioperative setting

Jonė Jackevičiūtė et al. Acta Med Litu. 2019.

Abstract
in English, Lithuanian

Background: The aim of the study was to identify the accuracy of and agreement between two non-invasive haemodynamic monitoring techniques in the perioperative setting - thoracic electrical bioimpedance (TEB) and Edwards Lifesciences ClearSight system (CS).

Materials and methods: The study included ten patients. Parametric quantitative data were expressed as mean ± SD. The Shapiro-Wilk test was used to test the normality of the distributions. A linear regression model was used to measure the strength of the linear relationship between TEB and CS. Bland-Altman analysis was performed to assess the mean difference, precision, and the limits of agreements (LOA). The Critchley and Critchley method was used to calculate the percentage error (PE), and if <30%, it was considered clinically acceptable.

Results: Ten patients were involved in our study. The mean cardiac output (CO) with TEB was 6.15 ± 1.14 L/min vs. 4.78 ± 1.40 L/min with CS (p < 0.01). The relationship was significant (n = 144; r 2 = 0.7; p < 0.01). The mean bias, LOA, and PE were 1.37 ± 1.01 L/min, 3.35 L/min and -0.61 L/min and 36.22%, respectively. The mean stroke volume index (SVI) with TEB was 48.64 ± 9.8 ml/beat/m2 vs. 37.12 ± 9.14 ml/beat/m2 with CS (p < 0.01). The relationship was significant (n = 144; r 2 = 0.65; p < 0.01). The mean bias, LOA, and PE were 11.52 ± 7.92 ml/beat/m2, 27.04 ml/beat/m2 and -4 ml/beat/m2 and 36.19%.

Conclusions: The two methods of non-invasive haemodynamic monitoring are not compatible in the perioperative setting. However, the CS system has more advantages in terms of continuity and simplicity of monitoring, while measurements of TEB are interrupted by electrocautery.

SantraukaĮvadas. Tyrimo tikslas – nustatyti dviejų neinvazinių hemodinamikos monitoravimo technikų tikslumą ir suderinamumą, lyginant bioimpedansą ir Edwards Lifesciences ClearSight sistemą.Tyrimo medžiaga ir metodai. Tyrime dalyvavo 10 pacientų. Kiekybiniai duomenys pateikti kaip aritmetiniai vidurkiai su standartiniu nuokrypiu. Skirstinio normalumui patikrinti naudotas Šapiro-Vilko testas. Tarpusavio ryšio stiprumui tarp bioimpedanso ir ClearSight įvertinti pasitelkta linijinė regresinė analizė. Bland-Altman analizė panaudota nustatant vidutinį skirtumą, tikslumą ir sutarties ribas. Critchley ir Critchley metodas buvo naudojamas apskaičiuojant procentinę paklaidą. Jei paklaida mažesnė nei 30 %, laikyta, kad ji kliniškai priimtina.Rezultatai. Vidutinis širdies minutinis tūris išmatuotas bioimpedansu; 6,15 ± 1,14 l/min., CS 4,78 ± 1,40 l/min. (p < 0,01). Nustatytas vidutinio stiprumo ryšys tarp minutinio širdies tūrio matavimų (n = 144; r 2 = 0,7; p < 0,01). Vidutinis skirtumas – 1,37 ± 1,01 l/min., sutarties ribos nuo 3,35 l/min. iki –0,61 l/min., paklaida – 36,22 %. Vidutinis sitolinio tūrio indeksas išmatuotas bioimpedansu: 48,64 ± 9,8 ml/susitraukimui/m2 ir CS 7,12 ± 9,14 ml/susitraukimui/m2 (p < 0,01). Nustatytas vidutinio stiprumo ryšys tarp sistolinio tūrio indekso matavimų (n = 144; r2 = 0,65; p < 0,01). Vidutinis skirtumas – 11,52 ± 7,92 ml/susitraukimui/m2, sutarties ribos: 27,04 ml/susitraukimui/m2 –4 ml/susitraukimui/m2 ir paklaida 36,19 %.Išvados. Šie neinvaziniai hemodinamikos stebėjimo metodai perioperaciniu laikotarpiu yra nesuderinami. Tačiau ClearSight pranašesnis dėl metodo paprastumo ir tęstinumo, o bioimpedanso matavimams įtaką darė elektrinio peilio naudojimas.Raktažodžiai: hemodinamikos stebėsena, minutinis širdies tūris, neinvazinis, intraoperacinis, pulso bangos analizė, bioimpedansas.

Keywords: bioimpedance; cardiac output; haemodynamic monitoring; intraoperative; non-invasive; pulse wave analysis.

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Figures

Fig. 1.
Fig. 1.
Linear regression analysis during anaesthesia between CO TEB and CO ClearSight (L/min)
Fig. 2.
Fig. 2.
Bland-Altman analysis during anaesthesia. The mean bias 1.37 L/min, LOA 3.35 L/min and –0.61 L/min. PE 36.22%
Fig. 3.
Fig. 3.
Linear regression analysis during anaesthesia between SV TEB and SV Clear- Sight (ml/beat)
Fig. 4.
Fig. 4.
Bland-Altman analysis during anaesthesia. The mean bias 21.34 ± 15.15 ml/beat, LOA 51.03 ml/beat, and – 8.35 ml/beat. PE 36.65%
See this image and copyright information in PMC

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