Accuracy and Trending Ability of the Fourth-Generation FloTrac/Vigileo System in Patients With Low Cardiac Index.
OBJECTIVE
To determine the accuracy and trending ability of the fourth-generation FloTrac/Vigileo in patients with low cardiac index by comparing FloTrac/Vigileo-derived cardiac index with that measured by 3-dimensional echocardiography.


METHODS
Prospective clinical study.


METHODS
Cardiac surgery operating room in a single cardiovascular center.


METHODS
Twenty-five patients undergoing elective cardiac resynchronization therapy lead implantation.


METHODS
FloTrac/Vigileo-derived cardiac index and 3-dimensional echocardiography-derived cardiac index were determined simultaneously before and after phenylephrine bolus and cardiac resynchronization therapy using 3-dimensional echocardiography-derived cardiac index as the reference method.


RESULTS
Cardiac index measured by the fourth-generation FloTrac/Vigileo had a wide limit of agreement with that measured by 3-dimensional echocardiography, with a percentage error of 59.1%. The tracking ability of the unit after both phenylephrine administration and cardiac resynchronization therapy were measured by concordance rate, and both were below the acceptable limit (72.7% and 85%, respectively).


CONCLUSIONS
The degree of accuracy of the fourth-generation FloTrac/Vigileo in patients with low cardiac index was not acceptable, and high systemic vascular resistance in patients with low cardiac index may have contributed to this inaccuracy. The tracking ability of the fourth-generation FloTrac/Vigileo after phenylephrine administration or cardiac resynchronization therapy was below acceptable limits.
Department of Anesthesiology, National Cerebral and Cardiovascular Center, Osaka, Japan.
Kohshi
K
Hattori
Department of Anesthesiology, National Cerebral and Cardiovascular Center, Osaka, Japan. Electronic address: takuma@ncvc.go.jp.
Takuma
T
Maeda
Department of Anesthesiology, National Cerebral and Cardiovascular Center, Osaka, Japan.
Tetsuhito
T
Masubuchi
Department of Anesthesiology, National Cerebral and Cardiovascular Center, Osaka, Japan.
Atsushi
A
Yoshikawa
Department of Anesthesiology, National Cerebral and Cardiovascular Center, Osaka, Japan.
Keigo
K
Ebuchi
Department of Anesthesiology, National Cerebral and Cardiovascular Center, Osaka, Japan.
Kuniko
K
Morishima
Department of Anesthesiology, National Cerebral and Cardiovascular Center, Osaka, Japan.
Masataka
M
Kamei
Department of Anesthesiology, National Cerebral and Cardiovascular Center, Osaka, Japan.
Kenji
K
Yoshitani
Department of Anesthesiology, National Cerebral and Cardiovascular Center, Osaka, Japan.
Yoshihiko
Y
Ohnishi
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000768:Anesthesia, General / Q000379:methods; D002302:Cardiac Output / Q000187:drug effects / Q000502:physiology; D058406:Cardiac Resynchronization Therapy / Q000379:methods*; D058409:Cardiac Resynchronization Therapy Devices; D019560:Echocardiography, Three-Dimensional / Q000379:methods; D005260:Female; D006333:Heart Failure / Q000628:therapy; D006439:Hemodynamics / Q000502:physiology; D006801:Humans; D008297:Male; D008875:Middle Aged; D016343:Monitoring, Intraoperative / Q000295:instrumentation / Q000379:methods* / Q000592:standards; D015588:Observer Variation; D010656:Phenylephrine / Q000494:pharmacology; D011446:Prospective Studies; D019919:Prosthesis Implantation / Q000379:methods; D015203:Reproducibility of Results; D013815:Thermodilution / Q000379:methods; D014662:Vasoconstrictor Agents / Q000494:pharmacology; D055815:Young Adult
D014662:Vasoconstrictor Agents; D010656:Phenylephrine
cardiac output; echocardiography; heart failure; measurement technique; monitoring; ultrasound