title: Uncalibrated continuous cardiac output measurement in liver transplant patients: LiDCOrapid™ system versus pulmonary artery catheter.
abstract: OBJECTIVE
  The aim of the study was to assess the level of agreement between continuous cardiac output estimated by uncalibrated pulse-power analysis (PulseCOLiR) and intermittent (ICO) and continuous cardiac output (CCO) obtained using a pulmonary artery catheter (PAC).
  
  
  METHODS
  Prospective cohort study.
  
  
  METHODS
  University hospital intensive care unit.
  
  
  METHODS
  Twenty patients after liver transplantation.
  
  
  METHODS
  Pulmonary artery catheters were placed in all patients, and ICO and CCO were determined using thermodilution. PulseCOLiR measurements were made using a LiDCOrapid(TM) (LiDCO Ltd, Cambridge, UK).
  
  
  RESULTS
  ICO data were determined after intensive care unit admission and every 8 hours until the 48th postoperative hour. CCO and PulseCOLiR measurements were recorded simultaneously at these same time intervals as well as hourly. For the 8-hour data set (140 data pairs), the mean bias and percentage errors (PE) were, respectively,-0.10 L/min and 39.2% for ICO versus PulseCOLiR and 0.79 L/min and 34.6% for CCO versus PulseCOLiR. For the hourly comparison of CCO versus PulseCOLiR (980 data pairs), the bias was 0.75 L/min and the PE 37%. To assess the ability to measure change, a 4-quadrant plot was produced for each pair of methods. The performance of PulseCOLiR was moderate in detecting changes in ICO.
  
  
  CONCLUSIONS
  In conclusion, the uncalibrated PulseCOLir method should not be used as a substitute for the thermodilution technique for the monitoring of cardiac output in liver transplant patients.
authors.affiliation: Department of Anesthesia and Intensive Care Medicine, Medical School of the University of Udine, Udine, Italy. Electronic address: gabriella.costa@uniud.it.
authors.forename: Maria Gabriella
authors.initials: MG
authors.lastname: Costa
authors.affiliation: Department of Anesthesia and Intensive Care Medicine, Medical School of the University of Udine, Udine, Italy.
authors.forename: Paolo
authors.initials: P
authors.lastname: Chiarandini
authors.affiliation: Clinical Epidemiology and Biometric Unit, IRCCS Policlinico San Matteo, Pavia, Italy.
authors.forename: Luigia
authors.initials: L
authors.lastname: Scudeller
authors.affiliation: Department of Anesthesia and Intensive Care Medicine, Medical School of the University of Udine, Udine, Italy.
authors.forename: Luigi
authors.initials: L
authors.lastname: Vetrugno
authors.affiliation: Department of Anesthesia and Intensive Care Medicine, Medical School of the University of Udine, Udine, Italy.
authors.forename: Livia
authors.initials: L
authors.lastname: Pompei
authors.affiliation: Department of Anesthesia and Intensive Care Medicine, Medical School of the University of Udine, Udine, Italy.
authors.forename: Giovanni
authors.initials: G
authors.lastname: Serena
authors.affiliation: Department of Anesthesia and Intensive Care Medicine, Medical School of the University of Udine, Udine, Italy.
authors.forename: Stefania
authors.initials: S
authors.lastname: Buttera
authors.affiliation: Department of Anesthesia and Intensive Care Medicine, Medical School of the University of Udine, Udine, Italy.
authors.forename: Giorgio
authors.initials: G
authors.lastname: Della Rocca
mesh_terms: D000328:Adult; D000368:Aged; D001011:Aorta; D002138:Calibration; D002302:Cardiac Output / Q000502:physiology*; D002406:Catheterization, Peripheral / Q000379:methods*; D015331:Cohort Studies; D005260:Female; D006439:Hemodynamics / Q000502:physiology; D006801:Humans; D016031:Liver Transplantation / Q000379:methods*; D008297:Male; D008875:Middle Aged; D016343:Monitoring, Intraoperative / Q000379:methods*; D011446:Prospective Studies; D011651:Pulmonary Artery / Q000502:physiology*; D011674:Pulse
keywords: cardiac output; intensive care; liver transplantation; measurement techniques; monitoring; thermodilution