title: [Reliability of the pulse contour analysis for cardiac output measurement for assessing the fluid responsiveness].
abstract: BACKGROUND
  The cardiac output (CO) is classically measured in intensive care unit patients. pulse contour (PC) method allows monitoring of CO.
  
  
  OBJECTIVE
  The aim of the present study was to assess the ability of PC to assess the fluid responsiveness defined as an increase in CO more than or equal to 15% after 500 mL hydroxyethyl starch over 20 minutes.
  
  
  METHODS
  In this observational prospective study, patients in shock in whom a PC method was inserted were included. CO was measure using the PC and thermodilution methods before and after a fluid challenge indicated by the physician. The correlation coefficient was measured, the diagram of Bland and Altman was built and the percentage of error (Critchley and Critchley method) was calculated. The ability of PC to diagnose fluid responsiveness was assessed using a receiver operating characteristics (ROC) curve.
  
  
  RESULTS
  Sixty-two fluid challenges were performed in 37 included patients. After fluid challenge, r(2) was 0.05 (P<0.01), the bias between PC and thermodilution was 0.3 ± 1.2L/min and the percentage of error was 36%. The area of the ROC curve was 0.601 [0.468-0.723].
  
  
  CONCLUSIONS
  In ICU patients with shock, PC cannot replace thermodilution to diagnose fluid responsiveness.
authors: Service des réanimations, division anesthésie réanimation douleur urgence, CHU de Nîmes, place du Pr. Robert-Debré, 30029 Nîmes cedex 9, France.
authors: V
authors: V
authors: Reubrecht
authors: G
authors: G
authors: Dingemans
authors: A
authors: A
authors: Gache
authors: O
authors: O
authors: Langeron
authors: J-L
authors: JL
authors: Faillie
authors: G
authors: G
authors: Gardès
authors: C
authors: C
authors: Bengler
authors: J-Y
authors: JY
authors: Lefrant
authors: L
authors: L
authors: Muller
mesh_terms: D000368:Aged; D002302:Cardiac Output; D005260:Female; D006801:Humans; D006895:Hydroxyethyl Starch Derivatives; D008297:Male; D011446:Prospective Studies; D011674:Pulse; D015203:Reproducibility of Results; D013815:Thermodilution
chemical_list: D006895:Hydroxyethyl Starch Derivatives