Echocardiography and pulse contour analysis to assess cardiac output in trauma patients

Area of Science:

• Critical Care Medicine
• Cardiovascular Physiology
• Hemodynamic Monitoring

Background:

• Echocardiography is vital for cardiac output (CO) assessment in trauma but lacks continuous monitoring.
• Pulse contour analysis, such as the MostCare system, offers beat-to-beat CO estimation.
• Current literature lacks direct comparison of MostCare with echocardiography in trauma patients.

Purpose of the Study:

• To compare cardiac output (CO) measurements obtained by the MostCare pulse contour analysis system (MC-CO) with those from transthoracic echocardiography (TTE-CO).
• To evaluate the agreement and correlation between these two methods for CO assessment in trauma patients.

Main Methods:

• A study involving 49 blunt trauma patients in intensive care requiring hemodynamic optimization.
• Simultaneous estimation of TTE-CO and MC-CO at baseline, after fluid challenge, and during vasoactive drug therapy.
• Analysis of 116 paired CO values to assess correlation, bias, and agreement.

Main Results:

• A strong correlation (0.94) was found between MC-CO and TTE-CO.
• The mean bias was -0.06 L·min⁻¹, with limits of agreement of -0.94 to 0.82 L·min⁻¹ and a percentage error of 18%.
• Changes in CO demonstrated a high correlation (0.91) with minimal bias (-0.01 L·min⁻¹).

Conclusions:

• MostCare pulse contour analysis demonstrates good agreement with transthoracic echocardiography for CO measurement in trauma patients.
• Pulse contour analysis serves as a valuable complementary tool to echocardiography for comprehensive hemodynamic assessment in this population.
• Continuous hemodynamic monitoring with MostCare can aid in timely clinical decision-making for trauma patients.