Comparison of the ability of two continuous cardiac output monitors to measure trends in cardiac output: estimated continuous cardiac output measured by modified pulse wave transit time and an arterial pulse contour-based cardiac output device
Comparison of the ability of two continuous cardiac output monitors to measure trends in cardiac output: estimated continuous cardiac output measured by modified pulse wave transit time and an arterial pulse contour-based cardiac output device
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DOI：
10.1007/s10877-015-9772-x
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发表时间：
2016-10-01
影响因子：
2.2
通讯作者：
Ochiai, Ryoichi
中科院分区：
文献类型：
--
作者：
Terada, Takashi;Oiwa, Ayano;Ochiai, Ryoichi
连续心输出量(EsCCO)是一种无创连续测量心输出量(CO)的技术，它基于修正的脉搏波通过时间，而脉搏波通过时间又由脉搏血氧饱和度和心电图确定。然而，在接受非心脏手术的患者中，它的趋势能力从未被评估过。因此，这项研究与目前可用的动脉波形分析方法相比，检验了esCCO在肾移植患者中检测CO准确变化的能力。使用esCCO系统和基于动脉压的CO(APCO)测量CO，并与相应的间歇性团注热稀释CO(ICO)方法进行比较。对15例成人患者的检查结果进行百分比误差分析和包括一致性分析和极图分析在内的统计学方法。ECCO与ICO的CO差值为-0.39+/-1.15Min(-1)(百分比误差，35.6%)。重复测量的校正精密度为1.16 L min(-1)(重复测量的百分比误差为36.0%)。一致性分析表明，符合率为93.1%。平均偏角为-1.8°，符合度径向极限为+/-37.6°。APCO值与ICOCO值之差为0.04+/-1.37Min(-1)，百分比误差为42.4%。重复测量的校正精密度为1.37Min(-1)(重复测量的误差百分比为42.5%)。符合率为89.7%，平均偏角为-3.3A度，符合度为+/-42.2A度。这项研究表明，根据极图分析判断，esCCO系统的趋势性能力在临床上是不可接受的；但基于一致性分析，其趋势性能力在临床上是可以接受的，并与目前可用的动脉波形分析方法相媲美。
Estimated continuous cardiac output (esCCO), a noninvasive technique for continuously measuring cardiac output (CO), is based on modified pulse wave transit time, which in turn is determined by pulse oximetry and electrocardiography. However, its trending ability has never been evaluated in patients undergoing non-cardiac surgery. Therefore, this study examined esCCO's ability to detect the exact changes in CO, compared with currently available arterial waveform analysis methods, in patients undergoing kidney transplantation. CO was measured using an esCCO system and arterial pressure-based CO (APCO), and compared with a corresponding intermittent bolus thermodilution CO (ICO) method. Percentage error and statistical methods, including concordance analysis and polar plot analysis, were used to analyze results from 15 adult patients. The difference in the CO values between esCCO and ICO was -0.39 +/- 1.15 L min(-1) (percentage error, 35.6 %). And corrected precision for repeated measures was 1.16 L min(-1) (percentage error for repeated measures, 36.0 %). A concordance analysis showed that the concordance rate was 93.1 %. The mean angular bias was -1.8A degrees and the radial limits of agreement were +/- 37.6A degrees. The difference between the APCO and ICO CO values was 0.04 +/- 1.37 L min(-1) (percentage error, 42.4 %). And corrected precision for repeated measures was 1.37 L min(-1) (percentage error for repeated measures, 42.5 %). The concordance rate was 89.7 %, with a mean angular bias of -3.3A degrees and radial limits of agreement of +/- 42.2A degrees. This study demonstrated that the trending ability of the esCCO system is not clinically acceptable, as judged by polar plots analysis; however, its trending ability is clinically acceptable based on a concordance analysis, and is comparable with currently available arterial waveform analysis methods.