Perioperative Continuous Noninvasive Cardiac Output Monitoring in Cardiac Surgery Patients by a Novel Capnodynamic Method.
J Cardiothorac Vasc Anesth
; 36(8 Pt B): 2900-2907, 2022 08.
Article
em En
| MEDLINE
| ID: mdl-35283043
ABSTRACT
OBJECTIVES:
To test the clinical performance of a novel continuous noninvasive cardiac output (CO) monitoring based on expired carbon dioxide kinetics in cardiac surgery patients.DESIGN:
A prospective feasibility pragmatic clinical study.SETTING:
A single-center, large community hospital.PARTICIPANTS:
Thirty-two patients undergoing cardiac surgery were studied during the intraoperative (before cardiopulmonary bypass) and postoperative (in the intensive care unit before extubation) periods.INTERVENTIONS:
CO was measured simultaneously by the continuous capnodynamic method and by transpulmonary thermodilution during changes in the patient's hemodynamic and/or respiratory conditions. MEASUREMENTS AND MAINRESULTS:
The current recommended comparative statistics for CO measurement methods were analyzed, including bias, precision, and percentage error obtained from Bland-Altman analysis, and concordance between methods obtained from the four-quadrant plot analysis to evaluate the trending ability. Bias ± limits of agreement and percentage error were -0.6 (-1.9 to +0.8; 95% CI of 3.73-5.25) L/min and 31% (n = 147 measurements) for the intraoperative period, -0.8 (-2.4 to +0.9; 95% CI of 3.03-5.21) L/min and 41% (n = 66) for the postoperative period, and -0.6 (-2.1 to +0.8; 95% CI of 3.74-5.00) L/min and 34% (n = 213) for the pooled data. The trending analysis obtained a concordance of 82% (n = 65) for the intraoperative and 71% (n = 24) for the early postoperative periods. Aggregation of both data sets gave a concordance of 79% (n = 89).CONCLUSIONS:
The continuous capnodynamic method was reliable and in good agreement with the reference method, and had an accuracy and trending ability good enough to make it a possible future alternative for hemodynamic monitoring in the studied population of elective adult cardiac surgery patients.Palavras-chave
Texto completo:
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Base de dados:
MEDLINE
Assunto principal:
Monitorização Intraoperatória
/
Procedimentos Cirúrgicos Cardíacos
Tipo de estudo:
Observational_studies
Limite:
Adult
/
Humans
Idioma:
En
Revista:
J Cardiothorac Vasc Anesth
Assunto da revista:
ANESTESIOLOGIA
/
CARDIOLOGIA
Ano de publicação:
2022
Tipo de documento:
Article
País de afiliação:
Argentina