title: Cardiac output measured by uncalibrated arterial pressure waveform analysis by recently released software version 3.02 versus thermodilution in septic shock.
abstract: To evaluate the 3.02 software version of the FloTrac/Vigileo™ system for estimation of cardiac output by uncalibrated arterial pressure waveform analysis, in septic shock. Nineteen consecutive patients in septic shock were studied. FloTrac/Vigileo™ measurements (COfv) were compared with pulmonary artery catheter thermodilution-derived cardiac output (COtd). The mean cardiac output was 7.7 L min(-1) and measurements correlated at r = 0.53 (P < 0.001, n = 314). In Bland-Altman plot for repeated measurements, the bias was 1.7 L min(-1) and 95 % limits of agreement (LA) were -3.0 to 6.5 L min(-1), with a %error of 53 %. The bias of COfv inversely related to systemic vascular resistance (SVR) (r = -0.54, P < 0.001). Above a SVR of 700 dyn s cm(-5) (n = 74), bias was 0.3 L min(-1) and 95 % LA were -1.6 to 2.2 L min(-1) (%error 32 %). Changes between consecutive measurements (n = 295) correlated at 0.67 (P < 0.001), with a bias of 0.1 % (95 % limits of agreement -17.5 to 17.0 %). All changes >10 % in both COtd and COfv (n = 46) were in the same direction. Eighty-five percent of the measurements were within the 30°-330° of the polar axis. COfv with the latest software still underestimates COtd at low SVR in septic shock. The tracking capacities of the 3.02 software are moderate-good when clinically relevant changes are considered.
authors.affiliation: Zaans Medical Centre, Koningin Julianaplein 58, Postbus 210, 1500 EE, Zaandam, The Netherlands. Slagtc@gmail.com
authors.forename: Cornelis
authors.initials: C
authors.lastname: Slagt
authors.forename: Marcel A
authors.initials: MA
authors.lastname: de Leeuw
authors.forename: Jan
authors.initials: J
authors.lastname: Beute
authors.forename: Emmy
authors.initials: E
authors.lastname: Rijnsburger
authors.forename: Martijn
authors.initials: M
authors.lastname: Hoeksema
authors.forename: Jan W R
authors.initials: JW
authors.lastname: Mulder
authors.forename: Ignacio
authors.initials: I
authors.lastname: Malagon
authors.forename: A B Johan
authors.initials: AB
authors.lastname: Groeneveld
mesh_terms: D000368:Aged; D000465:Algorithms; D062186:Arterial Pressure / Q000502:physiology*; D002138:Calibration; D002302:Cardiac Output / Q000502:physiology*; D057785:Catheters; D005260:Female; D006439:Hemodynamics; D006801:Humans; D008297:Male; D008875:Middle Aged; D016343:Monitoring, Intraoperative / Q000379:methods; D010865:Pilot Projects; D011312:Pressure; D011651:Pulmonary Artery / Q000473:pathology; D012772:Shock, Septic / Q000503:physiopathology; D012815:Signal Processing, Computer-Assisted; D012984:Software; D013815:Thermodilution