Are Noninvasive Continuous Cardiac Output Monitoring
Interchangeable with Esophageal Doppler?
Pisitsak C, MD¹, Luetrakool P, MD¹, Pisalayon M, BSc¹, Thamjamrassri T, MD¹
Affiliation : ¹ Department of Anesthesiology, Faculty of Medicine, Ramathibodi Hospital, Mahidol University, Bangkok, Thailand
Objective: To compare the trending ability, accuracy, and precision of non-invasive stroke volume (SV) measurement based on
a bioreactance technique and measurement of the pulse wave transit time (PWTT) versus the esophageal Doppler monitoring
(EDM).
Materials and Methods: Two hundred twenty-seven paired measurements from 10 patients who underwent abdominal surgery under general anesthesia were included for SV measurements. Pearson’s correlation coefficient was calculated, and Bland- Altman analysis was performed to evaluate the agreement between EDM and bioreactance (EDM-bioreactance) and between EDM and PWTT (EDM-PWTT).
Results: EDM-bioreactance had a correlation coefficient of 0.75 (95% confidence interval [CI] 0.62 to 0.78; p<0.001), bias of 0.28 ml (limits of agreement –30.92 to 31.38 ml), and percentage error of 46.82%. EDM-PWTT had a correlation coefficient of 0.48 (95% CI 0.44 to 0.72; p<0.001), bias of –0.18 ml (limits of agreement –40.28 to 39.92 ml), and percentage error of 60.17%. A subgroup analysis of data from patients who underwent crystalloid loading was performed to detect the trending ability. The four-quadrant plot analysis between EDM-bioreactance and EDM-PWTT demonstrated concordance rates of 70.00% and 73.68%, respectively.
Conclusion: SV measurement based on bioreactance technique and measurement of PWTT are not interchangeable with EDM. Trial registration : Thai Clinical Trials Registry, TCTR 20181217003
Received 2 Jul 2019 | Revised 14 Oct 2019 | Accepted 17 Oct 2019
doi.org/10.35755/jmedassocthai.2020.06.10413
Keywords : Stroke volume, Cardiac output, Doppler, Perioperative care, Pulse, Time
All Articles
Download