Pulse contour cardiac output: an evaluation of the FloTrac method.
OBJECTIVE
The aim of this study was to determine the agreement between pulmonary artery thermodilution (PA-TD) and a new pulse contour method (PCM), FloTrac/Vigileo version 1.0, and to asses the ability of FloTrac to track sudden changes in cardiac output.


METHODS
Cardiac output was determined twice after induction of anaesthesia, but before cardiac surgery, with both PA-TD and a PCM in order to determine the precision of both methods. The bias and agreement between the two methods were calculated using Bland-Altman analysis. Postoperatively, in patients with heart rates under 60 beats min(-1), atrial pacing was initiated and cardiac output was determined before and after with both methods.


RESULTS
Twenty-five patients were investigated. The precisions of PA-TD and the PCM were 0.35 (95% confidence interval +/-0.12) and 0.6 l min(-1) (95% confidence interval +/-0.21%). The bias between PA-TD and the PCM was -0.51 l min(-1) and the limits of agreement were +/-1.87 l min(-1) (95% confidence interval +/-0.39 and +/-0.66). The percentage error was 48%. The changes in cardiac output with atrial pacing were in the same direction in all nine patients.


CONCLUSIONS
In this study, agreement between PA-TD and the PCM was poor, but the PCM was able to track the direction of pace-induced changes in cardiac output.
Department of Anaesthesiology, Gentofte Hospital, University of Copenhagen, Denmark. morten.ostergaard@dadlnet.dk
Morten
M
Østergaard
Jonas
J
Nielsen
Eigil
E
Nygaard
D000328:Adult; D000368:Aged; D002302:Cardiac Output / Q000502:physiology*; D005260:Female; D006339:Heart Rate; D006801:Humans; D008297:Male; D008875:Middle Aged; D011184:Postoperative Period; D011651:Pulmonary Artery / Q000502:physiology; D011674:Pulse / Q000706:statistics & numerical data*; D013815:Thermodilution / Q000295:instrumentation* / Q000379:methods