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Comparison between continuous non-invasive estimated cardiac output by pulse wave transit time and thermodilution
Ashish C Sinha1, Preet Mohinder Singh, Navneet Grewal
1Department of Anaesthesia, Drexel University College of Medicine, Philadelphia, PA, USA.
Annals of Cardiac Anaesthesia
|October 5, 2014
Summary
The estimated continuous cardiac output (esCCO) method shows correlation with the thermodilution (TD) method for cardiac output measurement. However, the current error margin questions its clinical utility for therapeutic decisions.
Area of Science:
- Cardiovascular Physiology
- Critical Care Medicine
- Anesthesiology
Background:
- Cardiac output (CO) monitoring is crucial for patient management in critical care and anesthesia.
- Existing non-invasive CO monitoring methods often involve invasive components.
- The estimated continuous cardiac output (esCCO) system offers a potentially fully non-invasive approach.
Purpose of the Study:
- To evaluate the accuracy and reliability of the esCCO method for continuous cardiac output measurement.
- To compare esCCO measurements against the established thermodilution (TD) method using a pulmonary artery catheter (PAC).
Main Methods:
- A prospective study involving 14 adult surgical patients requiring PAC for CO monitoring.
- Simultaneous CO measurements were recorded using esCCO and TD methods.
- Bland-Altman analysis was employed to assess correlation and concordance between the two methods.
Main Results:
- A significant correlation (r = 0.6, P < 0.001) was observed between esCCO and TD measurements.
- Mean bias was 0.13 L/min with a 95% CI of -4.32 to 4.58 L/min.
- Mean precision was 6.56 L/min with a 95% CI of 2.27 to 10.85 L/min.
Conclusions:
- esCCO represents a truly non-invasive continuous cardiac output monitoring technique.
- While esCCO values correlate with the TD method, the current degree of error raises concerns about its clinical applicability for decision-making.
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