Objective
To compare the reliability of cardiac index (CI) and stroke-volume variation (SVV)
measured by the pulse-wave transit-time (PWTT) method using estimated continuous cardiac
output (esCCO) technique with conventional pulse-contour analysis after off-pump coronary
artery bypass grafting (OPCAB).
Design
A single-center, prospective, observational study.
Setting
At a 1,000-bed university hospital.
Participants
A total of 21 patients were enrolled after elective OPCAB.
Interventions
The study authors performed a method comparison study with simultaneous measurement
of CI and SVV based on the esCCO technique (CIesCCO and esSVV, correspondingly) and pulse-contour analysis (CIPCA and SVVPCA, correspondingly). As a secondary analysis, they also assessed the trending ability
of CIesCCO versus CIPCA.
Measurements and Main Results
The authors analyzed 178 measurement pairs for CI, and 174 pairs for SVV during the
10 study stages. The mean bias between CIesCCO and CIPCA was 0.06 L min/m2, with limits of agreement of ± 0.92 L min/m2 and a percentage error (PE) of 35.3%. The analysis of the trending ability of CI
measured by PWTT revealed a concordance rate of 70%. The mean bias between esSVV and
SVVPCA was –6.1%, with limits of agreement of ± 15.5% and a PE of 137%.
Conclusions
The overall performance of CIesCCO and esSVV versus CIPCA and SVVPCA is not clinically acceptable. A further improvement of the PWTT algorithm may be
required for an accurate and precise assessment of CI and SVV.
Key Words
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Article info
Publication history
Published online: February 11, 2023
Footnotes
This study was partially supported by a grant from Nihon Kohden (Japan).
Identification
Copyright
© 2023 Elsevier Inc. All rights reserved.
