title: Improved Performance of the Fourth-Generation FloTrac/Vigileo System for Tracking Cardiac Output Changes.
abstract: OBJECTIVE
  The aims of this study were to compare cardiac output (CO) measured by the new fourth-generation FloTrac™/Vigileo™ system (Version 4.00) (COFVS) with that measured by a pulmonary artery catheter (COREF), and to investigate the ability of COFVS to track CO changes induced by increased peripheral resistance.
  
  
  METHODS
  Prospective study.
  
  
  METHODS
  University Hospital.
  
  
  METHODS
  Twenty-three patients undergoing cardiac surgery.
  
  
  METHODS
  Phenylephrine (100 µg) was administered.
  
  
  RESULTS
  Hemodynamic variables, including CO(REF) and CO(FVS), were measured before and after phenylephrine administration. Bland-Altman analysis was used to assess the discrepancy between CO(REF) and CO(FVS). Four-quadrant plot and polar-plot analyses were utilized to evaluate the trending ability of CO(FVS) against CO(REF) after phenylephrine boluses. One hundred thirty-six hemodynamic interventions were performed. The bias shown by the Bland-Altman analysis was-0.66 L/min, and the percentage error was 55.4%. The bias was significantly correlated with the systemic vascular resistance index (SVRI) before phenylephrine administration (p<0.001, r(2) = 0.420). The concordance rate determined by four-quadrant plot analysis and the angular concordance rate calculated using polar-plot analysis were 87.0% and 83.0%, respectively. Additionally, this trending ability was not affected by SVRI state.
  
  
  CONCLUSIONS
  The trending ability of the new fourth-generation FloTrac™/Vigileo™ system after increased vasomotor tone was greatly improved compared with previous versions; however, the discrepancy of the new system in CO measurement was not clinically acceptable, as in previous versions. For clinical application in critically ill patients, this vasomotor tone-dependent disagreement must be decreased.
authors.affiliation: Department of Anesthesiology, Osaka City University Graduate School of Medicine, Osaka City, Osaka, Japan. Electronic address: suehirokoichi@yahoo.co.jp.
authors.forename: Koichi
authors.initials: K
authors.lastname: Suehiro
authors.affiliation: Department of Anesthesiology, Osaka City University Graduate School of Medicine, Osaka City, Osaka, Japan.
authors.forename: Katsuaki
authors.initials: K
authors.lastname: Tanaka
authors.affiliation: Department of Anesthesiology, Osaka City University Graduate School of Medicine, Osaka City, Osaka, Japan.
authors.forename: Mika
authors.initials: M
authors.lastname: Mikawa
authors.affiliation: Department of Anesthesiology, Osaka City University Graduate School of Medicine, Osaka City, Osaka, Japan.
authors.forename: Yuriko
authors.initials: Y
authors.lastname: Uchihara
authors.affiliation: Department of Anesthesiology, Osaka City University Graduate School of Medicine, Osaka City, Osaka, Japan.
authors.forename: Taiki
authors.initials: T
authors.lastname: Matsuyama
authors.affiliation: Department of Anesthesiology, Osaka City University Graduate School of Medicine, Osaka City, Osaka, Japan.
authors.forename: Tadashi
authors.initials: T
authors.lastname: Matsuura
authors.affiliation: Department of Anesthesiology, Osaka City University Graduate School of Medicine, Osaka City, Osaka, Japan.
authors.forename: Tomoharu
authors.initials: T
authors.lastname: Funao
authors.affiliation: Department of Anesthesiology, Osaka City University Graduate School of Medicine, Osaka City, Osaka, Japan.
authors.forename: Tokuhiro
authors.initials: T
authors.lastname: Yamada
authors.affiliation: Department of Anesthesiology, Osaka City University Graduate School of Medicine, Osaka City, Osaka, Japan.
authors.forename: Takashi
authors.initials: T
authors.lastname: Mori
authors.affiliation: Department of Anesthesiology, Osaka City University Graduate School of Medicine, Osaka City, Osaka, Japan.
authors.forename: Kiyonobu
authors.initials: K
authors.lastname: Nishikawa
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002302:Cardiac Output / Q000502:physiology*; D006348:Cardiac Surgical Procedures / Q000379:methods / Q000592:standards*; D002407:Catheterization, Swan-Ganz / Q000379:methods / Q000592:standards*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D016343:Monitoring, Intraoperative / Q000379:methods / Q000592:standards*; D011446:Prospective Studies; D013815:Thermodilution / Q000379:methods / Q000592:standards
keywords: FloTrac/Vigileo system; cardiac output; pulmonary artery catheter; systemic vascular resistance; thermodilution