Pulse Contour Analysis and Transesophageal Echocardiography: A Comparison of Measurements of Cardiac Output During Laparoscopic Colon Surgery
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Date
2009
Journal Title
Journal ISSN
Volume Title
Publisher
LIPPINCOTT WILLIAMS & WILKINS
Abstract
BACKGROUND: 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).
METHOD: 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 (COPWA). TEE CO (COTEE) 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.
RESULTS: Eighty-eight measurements were compared. The COTEE values ranged from 3.23 to 12 Lt/min (mean 6.21 +/- 1.85). Values for COPWA 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 COTEE and COPWA measurements was 40% (27%-50%) mean (range).
CONCLUSION: During laparoscopic colon surgery, clinically important differences were observed between CO determinations made with TEE and FTV. (Anesth Analg 2009;109:114-8)
METHOD: 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 (COPWA). TEE CO (COTEE) 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.
RESULTS: Eighty-eight measurements were compared. The COTEE values ranged from 3.23 to 12 Lt/min (mean 6.21 +/- 1.85). Values for COPWA 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 COTEE and COPWA measurements was 40% (27%-50%) mean (range).
CONCLUSION: During laparoscopic colon surgery, clinically important differences were observed between CO determinations made with TEE and FTV. (Anesth Analg 2009;109:114-8)
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Keywords
ARTERIAL-PRESSURE WAVE, THERMODILUTION TECHNIQUE, FORM ANALYSIS, CATHETERIZATION, ANESTHESIA, SYSTEM