Evaluation of an uncalibrated arterial pulse contour cardiac output monitoring system in cirrhotic patients undergoing liver surgery
Evaluation of an uncalibrated arterial pulse contour cardiac output monitoring system in cirrhotic patients undergoing liver surgery
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DOI：
10.1093/bja/aen343
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发表时间：
2009-01-01
影响因子：
9.8
通讯作者：
Filipponi, F.
中科院分区：
文献类型：
--
作者：
Biancofiore, G.;Critchley, L. A. H.;Filipponi, F.
背景：肺动脉导管具有侵入性，可能引起严重的并发症。需要一种安全的心输出量（CO）测量方法。我们评估了最近上市的自校准动脉脉搏轮廓CO监测系统（FloTrac/Vigileo（TM））在接受肝移植的终末期肝功能衰竭患者中的准确性和可靠性。改变的模式被称为缺血性心肌病，和移植程序本身，提供了一个评估在不同的临床conditions.Methods：心脏指数同时测量热稀释法（CITD：四个读数的平均值）使用肺动脉导管和脉冲轮廓分析（CIV：平均值计算的FloTrac/VigileoTM在同一时间段）。在肝移植手术期间（T1-T5）和重症监护室（T6-T10）的10个时间点进行读数。结果：共收集到29例患者的290对CIV数据。平均（SD）CITD为5.2（1.3），CIV为3.9（0.9）升min（-1）m（-2），读数之间的重复测量校正偏倚为1.3（0.2）升min（-1）m（-2），95%一致性限值为1.5（0.2）至4.1（0.3）升min（-1）m（-2）。误差百分比（2SD（偏倚）/平均CI（TD））为54%，超过了30%的可接受限度。外周阻力降低与偏倚增加相关（r=0.69; P
Background: The pulmonary artery catheter is invasive and may cause serious complications. A safe method of cardiac output (CO) measurement is needed. We have assessed the accuracy and reliability of a recently marketed self-calibrating arterial pulse contour CO monitoring system (FloTrac/Vigileo (TM)) in end-stage liver failure patients undergoing liver transplant. The pattern of alterations known as cirrhotic cardiomyopathy, and the transplant procedure itself, provided an evaluation under varying clinical conditions.Methods: The cardiac index was measured simultaneously by thermodilution (CITD: mean of four readings) using a pulmonary artery catheter and pulse contour analysis (CIV: mean value computed by the FloTrac/VigileoTM over the same time period). Readings were made at 10 time-points during liver transplant surgery (T1-T5) and on the intensive care unit (T6-T10). CIV was computed using the latest Vigileo software version 01.10.Results: A total of 290 paired readings from 29 patients were collected. Mean (SD) CITD was 5.2 (1.3) and CIV was 3.9 (0.9) litre min(-1) m(-2), with a corrected for repeated measures bias between readings of 1.3 (0.2) litre min(-1) m(-2) and 95% limits of agreement of 1.5 (0.2) to 4.1 (0.3) litre min(-1) m(-2). The percentage error (2SD(Bias)/meanCI(TD)) was 54%, which exceeded a 30% limit of acceptance. Low peripheral resistance and increasing bias were related (r=0.69; P