Calibrated versus uncalibrated arterial pressure waveform analysis in monitoring cardiac output with transpulmonary thermodilution in patients with severe sepsis and septic shock: An observational study

BACKGROUNDCardiac output (CO) measurement is often required in critically ill patients. The performances of newer, less invasive techniques require evaluation in patients with severe sepsis and septic shock. OBJECTIVESTo compare calibrated arterial pressure waveform analysis-derived CO (COap, VolumeView/EV1000) and the uncalibrated form (COfv, FloTrac/Vigileo) with transpulmonary thermodilution derived CO (COtptd). DESIGNA prospective, observational, single-centre study. SETTINGICU of a general teaching hospital. PATIENTSTwenty consecutive patients with severe sepsis or septic shock requiring haemodynamic monitoring by VolumeView/EV1000 and receiving mechanical ventilation. INTERVENTIONConnection of FloTrac/Vigileo to radial artery catheter already in situ. MAIN OUTCOME MEASURESRadial (COfv) and femoral (COap) arterial waveform-derived CO measurements were compared with COtptd with respect to bias, precision, limits of agreement and percentage error, and the percentage error in the course of time since the last calibration of COap by COtptd. RESULTSIn comparing COap with COtptd (n = 267 paired measurements), the bias was 0.02 and limits of agreement were −2.49 to 2.52 l min−1, with a percentage error of 31%. The percentage error between COap and COtptd remained less than 30% until 8 h after calibration. In comparing COfv with COtptd (n = 301), the bias was −0.86 l min−1 and limits of agreement were −4.48 to 2.77 l min−1, with a percentage err...
Source: European Journal of Anaesthesiology - Category: Anesthesiology Tags: Monitoring Source Type: research