title: Disagreement between fourth generation FloTrac and LiDCOrapid measurements of cardiac output and stroke volume variation during laparoscopic colectomy.
abstract: OBJECTIVE
  To determine the agreement between cardiac output (CO) and stroke volume variation (SVV) measured simultaneously by the fourth generation FloTrac/Vigileo system and LiDCOrapid system during pneumoperitoneum in patients undergoing laparoscopic colectomy.
  
  
  METHODS
  Retrospective observational study.
  
  
  METHODS
  Operating room in a general hospital.
  
  
  METHODS
  Ten patients (American Society of Anesthesiologist 1 or 2) without preoperative anemia.
  
  
  METHODS
  A 22-gauge catheter was inserted in the radial artery after induction of anesthesia. The arterial line was split to monitor CO and SVV simultaneously with the LiDCOrapid and fourth generation FloTrac/Vigileo systems. All data were downloaded from each system after surgery and simultaneous paired COFloTrac, COLiDCOand SVVFloTrac, SVVLiDCOvalues estimated every 1 minute during the pneumoperitoneum were analyzed.
  
  
  METHODS
  To assess the agreement after carbon dioxide insufflation, a scatter 4-quadrant plot was generated using paired ΔCO values (changes in COFloTracand COLiDCOjust before pneumoperitoneum and 3 minutes after the induction of pneumoperitoneum). For data in which SVVFloTracwas >9% but <16% and cardiac index measured by FloTrac/Vigileo was <2.5 L/min per m2during stable pneumoperitoneum (the period from 5 minutes after Trendelenburg position until discontinuation of pneumoperitoneum), simultaneously measured paired SVVFloTracand SVVLiDCOwere plotted every 1 minute using the Bland-Altman method.
  
  
  RESULTS
  A concordance ratio for changes in CO after the induction of pneumoperitoneum was 83% in 4-quadrant plot. During stable pneumoperitoneum, 702 paired SVVFloTracand SVVLiDCOmatched the criteria. These data sets were plotted by the Bland-Altman method and the bias and 95% limit of agreement of SVV were 2.01 and -2.63% to 6.65%, respectively, with 38% percentage error. The regression equation was SVVLiDCO= 0.98 × SVVFloTrac- 1.73 with Pearson correlation coefficient of 0.55.
  
  
  CONCLUSIONS
  Our study showed disagreement between the 2 methods and the hemodynamic parameters measured by one of the two devices should be interpreted with caution before therapeutic interventions.
authors.affiliation: Department of Anesthesiology, Kansai Electric Power Hospital, 2-1-7 Fukushima, Fukushima-ku, Osaka, 553-0003, Japan; Division of Anesthesiology and Critical Care Medicine, Kansai Electric Power Medical Research Institute, 2-1-7 Fukushima, Fukushima-ku, Osaka, 553-0003, Japan. Electronic address: nakasuji.masato@c3.kepco.co.jp.
authors.forename: Masato
authors.initials: M
authors.lastname: Nakasuji
authors.affiliation: Department of Anesthesiology, Kansai Electric Power Hospital, 2-1-7 Fukushima, Fukushima-ku, Osaka, 553-0003, Japan. Electronic address: kawasaki.aki@b2.kepco.co.jp.
authors.forename: Aki
authors.initials: A
authors.lastname: Okutani
authors.affiliation: Department of Anesthesiology, Kansai Electric Power Hospital, 2-1-7 Fukushima, Fukushima-ku, Osaka, 553-0003, Japan. Electronic address: miyata.taeko@a2.kepco.co.jp.
authors.forename: Taeko
authors.initials: T
authors.lastname: Miyata
authors.affiliation: Department of Anesthesiology, Kansai Electric Power Hospital, 2-1-7 Fukushima, Fukushima-ku, Osaka, 553-0003, Japan. Electronic address: imanaka.norie@d3.kepco.co.jp.
authors.forename: Norie
authors.initials: N
authors.lastname: Imanaka
authors.affiliation: Department of Anesthesiology, Kansai Electric Power Hospital, 2-1-7 Fukushima, Fukushima-ku, Osaka, 553-0003, Japan. Electronic address: tanaka.masuji@e2.kepco.co.jp.
authors.forename: Masuji
authors.initials: M
authors.lastname: Tanaka
authors.affiliation: Department of Anesthesiology, Kansai Electric Power Hospital, 2-1-7 Fukushima, Fukushima-ku, Osaka, 553-0003, Japan. Electronic address: kae-fuku@rb3.so-net.ne.jp.
authors.forename: Kae
authors.initials: K
authors.lastname: Nakasuji
authors.affiliation: Department of Anesthesiology, Kansai Electric Power Hospital, 2-1-7 Fukushima, Fukushima-ku, Osaka, 553-0003, Japan. Electronic address: yoshioka.miwako@e3.kepco.co.jp.
authors.forename: Miwako
authors.initials: M
authors.lastname: Nagai
mesh_terms: D000368:Aged; D000768:Anesthesia, General; D002245:Carbon Dioxide; D002302:Cardiac Output; D003082:Colectomy / Q000379:methods*; D005260:Female; D018475:Head-Down Tilt / Q000009:adverse effects; D006801:Humans; D007327:Insufflation; D010535:Laparoscopy / Q000379:methods*; D008297:Male; D008875:Middle Aged; D016343:Monitoring, Intraoperative / Q000295:instrumentation*; D011028:Pneumoperitoneum, Artificial; D012189:Retrospective Studies; D013318:Stroke Volume
chemical_list: D002245:Carbon Dioxide
keywords: FloTrac/Vigileo; Laparoscopic colectomy; LiDCO; Pneumoperitoneum