title: Accuracy of noninvasive estimated continuous cardiac output (esCCO) compared to thermodilution cardiac output: a pilot study in cardiac patients.
abstract: OBJECTIVE
  To compare the noninvasive estimated continuous cardiac output (esCCO), device-derived cardiac output (CO) to simultaneous pulmonary artery catheter (PAC) thermodilution (TD) CO.
  
  
  METHODS
  A prospective study comparing pulse wave transit time (estimated continuous cardiac output, esCCO; Nihon Kohden, Tokyo, Japan) to intermittent TD CO.
  
  
  METHODS
  One academic hospital.
  
  
  METHODS
  Patients presenting for cardiac surgery.
  
  
  METHODS
  Intraoperative CO measurements at 4 distinct time points (after induction, after sternotomy, after cardiopulmonary bypass, and after chest closure).
  
  
  RESULTS
  The study population consisted of American Society of Anesthesiologists (ASA) IV subjects, 27 (77%) males and 8 (23%) females, with a mean age of 64.6 ± 12.2 years. Data points from esCCO and TD were collected simultaneously and means per time point compared using Bland-Altman, Pearson R coefficient, and percent error. Mean TD CO for the study was 5.4 L/min. The Pearson R coefficient, percent error, and bias in L/min were: 0.57, 44%, 0.66 (after induction); 0.54, 51%, 0.88 (after sternotomy); 0.60, 60%, 0.95 (after cardiopulmonary bypass); and 0.57, 60%, 0.75 (after chest closure) respectively.
  
  
  CONCLUSIONS
  esCCO is easy to use and provides continuous CO measurements, but has wide limits of agreement and large percentage errors with a consistently positive bias in comparison to TD.
authors.affiliation: Department of Anesthesiology, Division of Cardiothoracic Anesthesiology, The Texas A&M University College of Medicine, Scott & White Memorial Hospital, Temple, TX. Electronic address: tball@sw.org.
authors.forename: Timothy R
authors.initials: TR
authors.lastname: Ball
authors.forename: Anthony P
authors.initials: AP
authors.lastname: Tricinella
authors.forename: B Alex
authors.initials: BA
authors.lastname: Kimbrough
authors.forename: Sarah
authors.initials: S
authors.lastname: Luna
authors.forename: David F
authors.initials: DF
authors.lastname: Gloyna
authors.forename: Frank J
authors.initials: FJ
authors.lastname: Villamaria
authors.forename: William C
authors.initials: WC
authors.lastname: Culp
mesh_terms: D000328:Adult; D000368:Aged; D000768:Anesthesia, General; D002302:Cardiac Output / Q000502:physiology*; D006348:Cardiac Surgical Procedures; D002315:Cardiopulmonary Bypass; D002407:Catheterization, Swan-Ganz; D005260:Female; D006331:Heart Diseases / Q000503:physiopathology*; D006801:Humans; D008297:Male; D008875:Middle Aged; D016343:Monitoring, Intraoperative; D010865:Pilot Projects; D011446:Prospective Studies; D013815:Thermodilution / Q000379:methods*
keywords: cardiac output; cardiac surgery; noninvasive monitoring; pulmonary artery catheter