Pulse Contour Analysis and Transesophageal Echocardiography: A Comparison of Measurements of Cardiac Output During Laparoscopic Colon Surgery
- 1 July 2009
- journal article
- research article
- Published by Ovid Technologies (Wolters Kluwer Health) in Anesthesia & Analgesia
- Vol. 109 (1), 114-118
- https://doi.org/10.1213/ane.0b013e3181a491b8
Abstract
Pulse wave analysis (PWA) allows cardiac output (CO) measurement after calibration by transpulmonary thermodilution. A PWA system that does not require previous calibration, the FloTrac/Vigileo (FTV), has been recently developed. We compared determinations of CO made with the FTV to simultaneous measurements using transesophageal echocardiography (TEE). Ten ASA I-II patients scheduled for laparoscopic colorectal surgery were studied. A radial 20-gauge cannula was inserted and connected to a hemodynamic monitor and a FTV system for PWA and determination of CO (CO(PWA)). TEE CO (CO(TEE)) was determined as previously described. Measurements were made after intubation, 5 min after establishing the lithotomy position, 5 min after establishing pneumoperitoneum, every 30 min, or each time mean arterial blood pressure decreased below basal values. Statistical analysis was made with the Bland and Altman method. Eighty-eight measurements were compared. The CO(TEE) values ranged from 3.23 to 12 Lt/min (mean 6.21 +/- 1.85). Values for CO(PWA) ranged from 2.9 to 8.5 Lt/min (mean 4.84 +/- 1.14). Bias was 1.17 and limits of agreement -2.02 and 4.37. The percentage error between all CO(TEE) and CO(PWA) measurements was 40% (27%-50%) mean (range). During laparoscopic colon surgery, clinically important differences were observed between CO determinations made with TEE and FTV.Keywords
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