title: Nexfin noninvasive continuous hemodynamic monitoring: validation against continuous pulse contour and intermittent transpulmonary thermodilution derived cardiac output in critically ill patients.
abstract: BACKGROUND
  Nexfin (Bmeye, Amsterdam, Netherlands) is a noninvasive cardiac output (CO) monitor based on finger arterial pulse contour analysis. The aim of this study was to validate Nexfin CO (NexCO) against thermodilution (TDCO) and pulse contour CO (CCO) by PiCCO (Pulsion Medical Systems, Munich, Germany).
  
  
  METHODS
  In a mix of critically ill patients (n = 45), NexCO and CCO were measured continuously and recorded at 2-hour intervals during the 8-hour study period. TDCO was measured at 0-4-8 hrs.
  
  
  RESULTS
  NexCO showed a moderate to good (significant) correlation with TDCO (R (2) 0.68, P < 0.001) and CCO (R (2) 0.71, P < 0.001). Bland and Altman analysis comparing NexCO with TDCO revealed a bias (± limits of agreement, LA) of 0.4 ± 2.32 L/min (with 36% error) while analysis comparing NexCO with CCO showed a bias (±LA) of 0.2 ± 2.32 L/min (37% error). NexCO is able to follow changes in TDCO and CCO during the same time interval (level of concordance 89.3% and 81%). Finally, polar plot analysis showed that trending capabilities were acceptable when changes in NexCO (ΔNexCO) were compared to ΔTDCO and ΔCCO (resp., 89% and 88.9% of changes were within the level of 10% limits of agreement).
  
  
  CONCLUSIONS
  we found a moderate to good correlation between CO measurements obtained with Nexfin and PiCCO.
authors: Department of Intensive Care Medicine, Ziekenhuis Netwerk Antwerpen, ZNA Stuivenberg, Lange Beeldekensstraat 267, 2060 Antwerp, Belgium.
authors: Koen
authors: K
authors: Ameloot
authors: Katrijn
authors: K
authors: Van De Vijver
authors: Ole
authors: O
authors: Broch
authors: Niels
authors: N
authors: Van Regenmortel
authors: Inneke
authors: I
authors: De Laet
authors: Karen
authors: K
authors: Schoonheydt
authors: Hilde
authors: H
authors: Dits
authors: Berthold
authors: B
authors: Bein
authors: Manu L N G
authors: ML
authors: Malbrain
mesh_terms: D001794:Blood Pressure / Q000502:physiology; D002302:Cardiac Output / Q000502:physiology*; D016638:Critical Illness; D005260:Female; D005385:Fingers / Q000098:blood supply; D006439:Hemodynamics / Q000502:physiology*; D006801:Humans; D008297:Male; D008875:Middle Aged; D008991:Monitoring, Physiologic / Q000379:methods*; D010991:Plethysmography / Q000379:methods; D011446:Prospective Studies; D011674:Pulse; D015203:Reproducibility of Results; D013815:Thermodilution / Q000379:methods