Improved Performance of the Fourth-Generation FloTrac/Vigileo System for Tracking Cardiac Output Changes
Improved Performance of the Fourth-Generation FloTrac/Vigileo System for Tracking Cardiac Output Changes
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DOI：
10.1053/j.jvca.2014.07.022
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发表时间：
2015-06-01
影响因子：
2.8
通讯作者：
Nishikawa, Kiyonobu
中科院分区：
文献类型：
--
作者：
Suehiro, Koichi;Tanaka, Katsuaki;Nishikawa, Kiyonobu
目的：本研究的目的是比较新的第四代FloTrac(TM)/Vigileo(TM)系统(版本4.00)(COFvs)测得的心输出量(CO)与由肺动脉导管(COREF)测得的心输出量(CO)，并探讨COFVS跟踪外周阻力增加引起的CO变化的能力。设计：前瞻性研究。背景：大学医院。参与者：23名接受心脏手术的患者。干预：服用苯肾上腺素(100 MU G)。测量和主要结果：测量血流动力学变量，包括COREF和COFVS。用Bland-Altman分析评估COREF和COFVS之间的差异。使用四象限图和极图分析来评估COFVS在苯肾上腺素团注后对COREF的趋势能力。共进行了136次血流动力学干预。Bland-Altman分析的偏差为-0.66 L/分，百分比误差为55.4%。该偏差与苯肾上腺素用药前的全身血管阻力指数显著相关(p<；0.001，r(2)=0.420)。四象限分析的符合率为87.0%，极图分析计算的角度符合率为83.0%。结论：新的第四代FloTra(TM)/Vigileo(TM)系统在增加血管舒张性张力后的趋势能力比以前的版本有了很大的提高，但新系统在CO测量方面的差异不像以前的版本那样在临床上是不可接受的。对于危重病患者的临床应用，这种血管舒缩张力依赖的不一致必须减少。(C)2015 Elsevier Inc.保留所有权利。
Objectives: The aims of this study were to compare cardiac output (CO) measured by the new fourth-generation FloTrac (TM)/Vigileo (TM) 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.Design: Prospective study.Setting: University Hospital.Participants: Twenty-three patients undergoing cardiac surgery.Interventions: Phenylephrine (100 mu g) was administered.Measurements and Main Results: Hemodynamic variables, including COREF and COFVS, were measured before and after phenylephrine administration. Bland-Altman analysis was used to assess the discrepancy between COREF and COFVS. Four-quadrant plot and polar-plot analyses were utilized to evaluate the trending ability of COFVS against COREF 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 FloTra (TM)/Vigileo (TM) 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. (C) 2015 Elsevier Inc. All rights reserved.