The uncalibrated pulse contour cardiac output during off-pump coronary bypass surgery

Performance in patients with a low cardiac output status and a reduced left ventricular function

Youn Yi Jo, Jong Wook Song, Young Chul Yoo, Ji Young Park, Jae Kwang Shim, Younglan Kwak

Research output: Contribution to journalArticle

14 Citations (Scopus)

Abstract

Background: We compared the continuous cardiac index measured by the FloTrac/Vigileo™ system (FCI) to that measured by a pulmonary artery catheter (CCI) with emphasis on the accuracy of the FCI in patients with a decreased left ventricular ejection fraction (LVEF) and a low cardiac output status during off-pump coronary bypass surgery (OPCAB). We also assessed the influence of several factors affecting the pulse contour, such as the mean arterial pressure (MAP), the systemic vascular resistance index (SVRI) and the use of norepinephrine. Methods: Fifty patients who were undergoing OPCAB (30 patients with a LVEF ≥ 40%, 20 patients with a LVEF < 40%) were enrolled. The FCI and CCI were measured and we performed a Bland-Altman analysis. Subgroup analyses were done according to the LVEF (< 40%), the CCI (≤ 2.4 L/min/m), the MAP (60-80 mmHg), the SVRI (1,600-2,600 dyne/s/cm5/m2) and the use of norepinephrine. Results: The FCI was reliable at all the time points of measurement with an overall bias and limit of agreement of -0.07 and 0.67 L/min/m2, respectively, resulting in a percentage error of 26.9%. The percentage errors in the patients with a decreased LVEF and in a low cardiac output status were 28.2% and 22.3%, respectively. However, the percentage error in the 91 data pairs outside the normal range of the SVRI was 40.2%. Conclusions: The cardiac output measured by the FloTrac/Vigileo™ system was reliable even in patients with a decreased LVEF and in a low cardiac output status during OPCAB. Acceptable agreement was also noted during the period of heart displacement and grafting of the obtuse marginalis branch.

Original languageEnglish
Pages (from-to)237-243
Number of pages7
JournalKorean Journal of Anesthesiology
Volume60
Issue number4
DOIs
Publication statusPublished - 2011 Apr 1

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Low Cardiac Output
Left Ventricular Function
Cardiac Output
Stroke Volume
Pulse
Vascular Resistance
Norepinephrine
Arterial Pressure
Heart Transplantation
Pulmonary Artery
Reference Values
Catheters

All Science Journal Classification (ASJC) codes

  • Anesthesiology and Pain Medicine

Cite this

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title = "The uncalibrated pulse contour cardiac output during off-pump coronary bypass surgery: Performance in patients with a low cardiac output status and a reduced left ventricular function",
abstract = "Background: We compared the continuous cardiac index measured by the FloTrac/Vigileo™ system (FCI) to that measured by a pulmonary artery catheter (CCI) with emphasis on the accuracy of the FCI in patients with a decreased left ventricular ejection fraction (LVEF) and a low cardiac output status during off-pump coronary bypass surgery (OPCAB). We also assessed the influence of several factors affecting the pulse contour, such as the mean arterial pressure (MAP), the systemic vascular resistance index (SVRI) and the use of norepinephrine. Methods: Fifty patients who were undergoing OPCAB (30 patients with a LVEF ≥ 40{\%}, 20 patients with a LVEF < 40{\%}) were enrolled. The FCI and CCI were measured and we performed a Bland-Altman analysis. Subgroup analyses were done according to the LVEF (< 40{\%}), the CCI (≤ 2.4 L/min/m), the MAP (60-80 mmHg), the SVRI (1,600-2,600 dyne/s/cm5/m2) and the use of norepinephrine. Results: The FCI was reliable at all the time points of measurement with an overall bias and limit of agreement of -0.07 and 0.67 L/min/m2, respectively, resulting in a percentage error of 26.9{\%}. The percentage errors in the patients with a decreased LVEF and in a low cardiac output status were 28.2{\%} and 22.3{\%}, respectively. However, the percentage error in the 91 data pairs outside the normal range of the SVRI was 40.2{\%}. Conclusions: The cardiac output measured by the FloTrac/Vigileo™ system was reliable even in patients with a decreased LVEF and in a low cardiac output status during OPCAB. Acceptable agreement was also noted during the period of heart displacement and grafting of the obtuse marginalis branch.",
author = "Jo, {Youn Yi} and Song, {Jong Wook} and Yoo, {Young Chul} and Park, {Ji Young} and Shim, {Jae Kwang} and Younglan Kwak",
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The uncalibrated pulse contour cardiac output during off-pump coronary bypass surgery : Performance in patients with a low cardiac output status and a reduced left ventricular function. / Jo, Youn Yi; Song, Jong Wook; Yoo, Young Chul; Park, Ji Young; Shim, Jae Kwang; Kwak, Younglan.

In: Korean Journal of Anesthesiology, Vol. 60, No. 4, 01.04.2011, p. 237-243.

Research output: Contribution to journalArticle

TY - JOUR

T1 - The uncalibrated pulse contour cardiac output during off-pump coronary bypass surgery

T2 - Performance in patients with a low cardiac output status and a reduced left ventricular function

AU - Jo, Youn Yi

AU - Song, Jong Wook

AU - Yoo, Young Chul

AU - Park, Ji Young

AU - Shim, Jae Kwang

AU - Kwak, Younglan

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N2 - Background: We compared the continuous cardiac index measured by the FloTrac/Vigileo™ system (FCI) to that measured by a pulmonary artery catheter (CCI) with emphasis on the accuracy of the FCI in patients with a decreased left ventricular ejection fraction (LVEF) and a low cardiac output status during off-pump coronary bypass surgery (OPCAB). We also assessed the influence of several factors affecting the pulse contour, such as the mean arterial pressure (MAP), the systemic vascular resistance index (SVRI) and the use of norepinephrine. Methods: Fifty patients who were undergoing OPCAB (30 patients with a LVEF ≥ 40%, 20 patients with a LVEF < 40%) were enrolled. The FCI and CCI were measured and we performed a Bland-Altman analysis. Subgroup analyses were done according to the LVEF (< 40%), the CCI (≤ 2.4 L/min/m), the MAP (60-80 mmHg), the SVRI (1,600-2,600 dyne/s/cm5/m2) and the use of norepinephrine. Results: The FCI was reliable at all the time points of measurement with an overall bias and limit of agreement of -0.07 and 0.67 L/min/m2, respectively, resulting in a percentage error of 26.9%. The percentage errors in the patients with a decreased LVEF and in a low cardiac output status were 28.2% and 22.3%, respectively. However, the percentage error in the 91 data pairs outside the normal range of the SVRI was 40.2%. Conclusions: The cardiac output measured by the FloTrac/Vigileo™ system was reliable even in patients with a decreased LVEF and in a low cardiac output status during OPCAB. Acceptable agreement was also noted during the period of heart displacement and grafting of the obtuse marginalis branch.

AB - Background: We compared the continuous cardiac index measured by the FloTrac/Vigileo™ system (FCI) to that measured by a pulmonary artery catheter (CCI) with emphasis on the accuracy of the FCI in patients with a decreased left ventricular ejection fraction (LVEF) and a low cardiac output status during off-pump coronary bypass surgery (OPCAB). We also assessed the influence of several factors affecting the pulse contour, such as the mean arterial pressure (MAP), the systemic vascular resistance index (SVRI) and the use of norepinephrine. Methods: Fifty patients who were undergoing OPCAB (30 patients with a LVEF ≥ 40%, 20 patients with a LVEF < 40%) were enrolled. The FCI and CCI were measured and we performed a Bland-Altman analysis. Subgroup analyses were done according to the LVEF (< 40%), the CCI (≤ 2.4 L/min/m), the MAP (60-80 mmHg), the SVRI (1,600-2,600 dyne/s/cm5/m2) and the use of norepinephrine. Results: The FCI was reliable at all the time points of measurement with an overall bias and limit of agreement of -0.07 and 0.67 L/min/m2, respectively, resulting in a percentage error of 26.9%. The percentage errors in the patients with a decreased LVEF and in a low cardiac output status were 28.2% and 22.3%, respectively. However, the percentage error in the 91 data pairs outside the normal range of the SVRI was 40.2%. Conclusions: The cardiac output measured by the FloTrac/Vigileo™ system was reliable even in patients with a decreased LVEF and in a low cardiac output status during OPCAB. Acceptable agreement was also noted during the period of heart displacement and grafting of the obtuse marginalis branch.

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