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Accuracy of Cardiac Output by Nine Different Pulse Contour Algorithms in Cardiac Surgery Patients: A Comparison with

Ole Broch1, Berthold Bein2, Matthias Gruenewald1

  • 1Department of Anesthesiology and Intensive Care Medicine, University Hospital Schleswig-Holstein, Campus Kiel, Schleswig-Holstein, Germany.

Biomed Research International
|January 25, 2017
PubMed

Insights

Nine cardiac output (CO) algorithms showed poor accuracy compared to transpulmonary thermodilution before and after cardiopulmonary bypass. The Liljestrand-Zander algorithm demonstrated the highest reliability for CO estimation.

Area of Science:

  • Cardiovascular Physiology
  • Medical Devices
  • Surgical Innovation

Background:

  • Cardiac output (CO) monitoring is crucial in critical care and surgery.
  • Various pulse contour analysis algorithms exist for non-invasive CO estimation.
  • Transpulmonary thermodilution is a reference standard for CO measurement.

Purpose of the Study:

  • To compare the accuracy of nine pulse contour algorithms against transpulmonary thermodilution.
  • To evaluate CO estimation before and after cardiopulmonary bypass (CPB).
  • To assess the trending capability of algorithms during hemodynamic changes.

Main Methods:

  • Thirty patients undergoing coronary surgery were studied.
  • CO measured by transpulmonary thermodilution (CO_TPTD) and nine pulse contour algorithms (CO_X1-9).
  • Algorithms calibrated using esophageal Doppler; passive leg raising maneuver performed.

Main Results:

  • Poor correlation and high percentage error (>30%) between pulse contour algorithms and CO_TPTD.
  • Most algorithms exhibited insufficient trending ability before and after CPB.
  • The Liljestrand-Zander algorithm showed the best reliability among tested methods.

Conclusions:

  • Nine pulse contour algorithms demonstrated inadequate accuracy for CO estimation compared to transpulmonary thermodilution.
  • Less-invasive algorithms had insufficient capability for trending hemodynamic changes post-CPB.
  • The Liljestrand-Zander algorithm is the most reliable among the evaluated pulse contour methods.

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