[Semi-invasive monitoring of cardiac output in renal transplantation by a new device using arterial pressure waveform analysis compare with intermittent pulmonary thermodilution].
BACKGROUND
Clinical usefulness of PA catheter is controversial. We compared a new semi-invasive device (FloTrac/Vigileo) using arterial pressure waveform analysis for CO measurement in patients undergoing renal transplantation with bolus thermodilution method. Simultaneously CCO was measured, and we compared CCO with that obtained by bolus thermodilution method.


METHODS
Forty seven patients undergoing renal transplantation were enrolled. A PAC was inserted and radial arterial access was used for semi-invasive determination of CO (APCO) with the Vigileo. CO was measured simultaneously by bolus thermodilution and the Vigileo technique, and after starting operation, volume loading, before surgery, and other points were measured over 1 hour during measurements. And CCO was measured simultaneously at all points.


METHODS
Statistical analysis was performed using the method described by Bland and Altman. Bias was defined as the mean difference between the volumes obtained by pulmonary artery thermodilution and those by arterial pressure waveform analysis. Precision was expressed by the upper and lower limits of agreement.


RESULTS
Means of age, height and weight were 45 years, 163.8 cm and 59.2 kg, respectively. Regression analysis of CO; APCO and ICO showed y = 0.8x + 2.2, R2 = 0.57. CCO and ICO; y = 0.8x + 1.1, R2 = 0.74. Average of APCO and ICO; bias = -0.65. SD = 1.54 average of CCO and ICO; bias = 0.38, SD = 1.23.


CONCLUSIONS
In renal transplantation, CO measured by a new semi-invasive arterial pressure waveform analysis device showed good agreement with the volume obtained by intermittent pulmonary artery thermodilution method.
Terada
Takashi
T
First Department of Anesthesiology, Toho University School of Medicine, Tokyo 143-8541.
Maemura
Yumi
Y
Toyoda
Daisuke
D
Iwasaki
Ririko
R
Sato
Nobukazu
N
Ochtai
Ryoichi
R
D001795:Blood Pressure Determination / Q000379:methods*; D002302:Cardiac Output; D005260:Female; D006801:Humans; D016030:Kidney Transplantation; D008168:Lung / Q000098:blood supply*; D008297:Male; D008875:Middle Aged; D011300:Preoperative Care; D013815:Thermodilution / Q000379:methods*