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Fourth Generation FloTrac Software Pulse Contour Analysis for Measuring and Trending Cardiac Output: A Method
Caroline Dinesen1,2, Simon Tilma Vistisen2, Rasmus Aagaard1,2,3
1Department of Cardiothoracic and Vascular Surgery, Anesthesia Section, Aarhus University Hospital, Aarhus, Denmark.
The FloTrac method, a minimally invasive cardiac output monitor, is not interchangeable with the thermodilution method in post-cardiac surgery patients due to unacceptable percentage errors and limited trending ability.
Area of Science:
- Cardiovascular physiology
- Medical device evaluation
- Hemodynamic monitoring
Background:
- Accurate cardiac output (CO) assessment is vital for hemodynamic management.
- The FloTrac system offers minimally invasive, continuous CO estimation.
- This study compared the FloTrac method to pulmonary artery catheter thermodilution.
Purpose of the Study:
- To evaluate the accuracy, precision, and trending performance of the FloTrac method.
- To compare FloTrac CO measurements against thermodilution (TD) CO measurements.
- To determine the interchangeability of FloTrac with TD in cardiac surgery patients.
Main Methods:
- Prospective interventional study of 41 cardiac surgery patients.
- Simultaneous CO measurements using FloTrac and TD before/after preload interventions.
- Analysis of bias, limits of agreement, percentage error (PE), and concordance rates.
Main Results:
- Bias ranged from -0.36 to 0.79 L/min; limits of agreement were wide.
- Percentage errors (PE) exceeded the 30% threshold (35-42%).
- Concordance rates were below the 90% criterion (72-85%).
Conclusions:
- The FloTrac method did not meet interchangeability criteria with thermodilution.
- Unacceptable percentage errors and poor trending limit FloTrac's clinical utility.
- FloTrac's accuracy and precision are insufficient for this patient population.
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