Agreement between different non-invasive methods of ventricular elastance assessment for the monitoring of ventricular –arterial coupling in intensive care

The objective of the present study was to determine whether ESP/ESV simplification can be used instead of the Chen formula to measure ventricular –arterial coupling and to monitor changes following therapeutic intervention. In this retrospective, single-center study, 3 non-invasive EA/Ees calculation methods were applied to 86 cardiac ICU patients. The Chen method was used as the reference method. Ees was also calculated according to method 1: Ees1 = 0.9 × SAP/ESV and method 2: Ees2=  EA/(1/LVEF)  − 1. EA was estimated as 0.9  × SAP/SV (mmHg ml−1).  After simplification: EA/Ees1  = EA/Ees2  = (1/LVEF) − 1, with the stroke volume estimated as the product of the aortic velocity–time integral (VTIAo) and the aortic area or as the difference between the end diastolic volume (EDV) and the ESV. All patients received fluid infusion, norepinephrine, or dobutamine. At basel ine, the concordance correlation coefficient with EA/EesChen was 0.13 [ − 0.07; 0.31] for EA/Ees1 and 0.32 [0.19; 0.44] for EA/Ees2. Bias and limit of agreement were 0.28 [ − 0.02; 0.36] and [− 5.8; 2.6] for EA/Ees1 and of 0.44 [0.31; 0.53] and [ − 3.2; 2.6] for EA/Ees2. When used to follow variations in EA/Ees following therapeutic interventions, only 65% (for EA/Ees1) and 70% (for EA/Ees2) of measures followed the same trend as EA/EesChen. Our results do not support the use of ESP/ESV based method as substitute for Chen method to measure and asse...
Source: Journal of Clinical Monitoring and Computing - Category: Information Technology Source Type: research