FloTrac/Vigileo(TM) (third generation) and MostCare(®)/PRAM versus echocardiography for cardiac output estimation in vascular surgery.
OBJECTIVE
To compare the FloTrac/Vigileo(TM) cardiac output (COFT/V) and the MostCare(®)/PRAM cardiac output (COMC/P) versus transthoracic echocardiographic cardiac output estimation (reference method; CO(ECHO)).


METHODS
Prospective observational study.


METHODS
Single center, Cardio-Thoracic and Vascular Surgery/Intensive Care Unit.


METHODS
Patients undergoing elective vascular surgery.


METHODS
Cardiac output measurement with two pulse contour methods: the FloTrac/Vigileo(TM) and the MostCare(®)/PRAM before (T1) and after (T2) fluid loading versus echocardiography (reference method).


RESULTS
One hundred fifty-six CO measurements were performed in 26 patients. The data showed poor agreement between CO(ECHO) and CO(FT/V): r(2) = 0.29 (T1) and 0.27 (T2); bias -0.37 (T1) and -0.40 (T2) L/min; limits of agreement from -3.10 to 2.42 (T1) and from -3.0 to 2.2 (T2) L/min. The percentage error was 51.7% (T1) and 49.3% (T2). Conversely, COMC/P resulted in agreement with echocardiography: r(2) = 0.76 (T1) and 0.80 (T2); bias -0.01 (T1) and -0.06 (T2) L/min; limits of agreement from -1.13 to 1.11 (T1) and from -0.90 to 0.80 (T2) L/min, with a PE of 22.4% (T1) and of 17.0% (T2).


CONCLUSIONS
In patients undergoing vascular surgery, the FloTrac/Vigileo(TM) did not demonstrate that it was a reliable system for CO monitoring when compared with echocardiography-derived CO. However, MostCare(®)/PRAM was shown to estimate CO with a good level of agreement with echocardiographic measures.
Department of Heart and Vessels, Cardio-Thoracic and Vascular Anaesthesia and Intensive Care, Azienda Ospedaliero-Universitaria Careggi, Florence, Italy. Electronic address: stefano-romagnoli@hotmail.com.
Stefano
S
Romagnoli
Zaccaria
Z
Ricci
Salvatore M
SM
Romano
Fabio
F
Dimizio
Eleonora
E
Bonicolini
Diego
D
Quattrone
Raffaele
R
De Gaudio
D000368:Aged; D000369:Aged, 80 and over; D002302:Cardiac Output / Q000502:physiology*; D004452:Echocardiography / Q000379:methods*; D005260:Female; D006439:Hemodynamics / Q000502:physiology; D006801:Humans; D016014:Linear Models; D008297:Male; D008875:Middle Aged; D016343:Monitoring, Intraoperative / Q000295:instrumentation* / Q000379:methods*; D011446:Prospective Studies; D015203:Reproducibility of Results; D014656:Vascular Surgical Procedures / Q000379:methods*
FloTrac; MostCare; PRAM; Vigileo; cardiac output; cardiac output monitors; goal-directed therapy; pulse contour methods; vascular surgery