1. Ability of the Third-Generation FloTrac/Vigileo Software to Track Changes in Cardiac Output in Cardiac Surgery Patients: A Polar Plot Approach
- Author
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Olivier Bastien, Roland Henaine, Catherine Koffel, Jean-Jacques Lehot, Lester A. H. Critchley, Olivier Desebbe, Marek Haftek, Hans Garcia, Pascal Rosamel, Jean-François Obadia, Geoffray Keller, Service d'anesthésiologie et de soins intensifs, Hospices Civils de Lyon (HCL)-Hôpital Louis Pradel [CHU - HCL], Hospices Civils de Lyon (HCL), Fonctions Normales et Pathologiques de la Barrière Cutanée [Hôpital Edouard Herriot - HCL], Université Claude Bernard Lyon 1 (UCBL), Université de Lyon-Université de Lyon-Hôpital Edouard Herriot [CHU - HCL], Hospices Civils de Lyon (HCL)-Hospices Civils de Lyon (HCL), Service de chirurgie cardiaque, Hospices Civils de Lyon (HCL)-Hôpital neurologique et neurochirurgical Pierre Wertheimer [CHU - HCL], Anaesthesia and Intensive Care, and The Chinese University of Hong Kong [Hong Kong]-Prince of Wales Hospital
- Subjects
Adult ,Male ,medicine.medical_specialty ,Cardiac output ,MESH: Heart Valve Prosthesis ,medicine.medical_treatment ,Thermodilution ,MESH: Prostheses and Implants ,030204 cardiovascular system & hematology ,law.invention ,MESH: Marfan Syndrome ,03 medical and health sciences ,0302 clinical medicine ,030202 anesthesiology ,law ,Monitoring, Intraoperative ,Internal medicine ,medicine ,Humans ,Prospective Studies ,Polar plot ,Cardiac Output ,Cardiac Surgical Procedures ,Aged ,Hetastarch ,Aged, 80 and over ,MESH: Humans ,business.industry ,Hemodynamics ,Pulmonary artery catheter ,Repeated measures design ,MESH: Adult ,MESH: Aortic Valve Insufficiency ,Middle Aged ,Intensive care unit ,MESH: Male ,MESH: Aortic Aneurysm ,Cardiac surgery ,Anesthesiology and Pain Medicine ,ROC Curve ,Cardiothoracic surgery ,Data Interpretation, Statistical ,Anesthesia ,Cardiology ,Female ,Cardiology and Cardiovascular Medicine ,business ,Software ,[SDV.MHEP]Life Sciences [q-bio]/Human health and pathology - Abstract
International audience; OBJECTIVE: To evaluate the ability of the third-generation (3.01) of FloTrac/Vigileo monitor (Edwards Lifesciences, Irvine, CA) to follow variations in cardiac output (∆CO) using the new polar plot approach. DESIGN: Prospective interventional study. SETTING: Single hospital university study. PARTICIPANTS: Twenty-five patients referred for cardiac surgery. INTERVENTIONS: CO was measured simultaneously by 3 to 5 bolus thermodilution (COtd measurements), using a pulmonary artery catheter and by arterial pulse contour analysis, using the FloTrac/Vigileo (COvi). Data were collected at eight time points: before incision, after sternotomy, before and after protamine sulfate infusion, at the start of sternal closure, at the end of surgery, on arrival to intensive care unit, and after a standardized volume expansion with 500 mL of hetastarch 6%. MEASUREMENTS AND MAIN RESULTS: One-hundred thirty-five pairs of CO data were collected; the mean bias of all CO measurements corrected for repeated measures was 0.2 L/min with limits of agreements of -3.3 L/min and +2.9 L/min. The percentage error was 66.5%. The polar plot analysis included 71 significant ∆CO and showed a mean polar angle of -3.4 degrees with 95% polar percentage error equivalent limits of -61 to 55; 69% of analysed data points fell within the 30-degree limits and provided a correct polar concordance rate. CONCLUSIONS: Third-generation FloTrac/Vigileo software still lacks the accuracy to reliably detect changes in cardiac output (∆CO) in cardiac surgery. Improvements to FloTrac/Vigileo CO algorithm and software still are needed in this particular setting.
- Published
- 2013