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Continuous intraoperative noninvasive cardiac output monitoring using a new thoracic bioimpedance device
D Thangathurai1, C Charbonnet, P Roessler
1Department of Anesthesiology, University of Southern California School of Medicine, Los Angeles, USA.
Objectives:
To compare a new noninvasive bioimpedance device with the standard thermodilution method during the intraoperative period in high-risk patients undergoing oncological surgery.
Design:
Prospectively collected data with retrospective analysis.
Setting:
The study was undertaken at a university hospital, single institution.
Participants:
Twenty-three selected adults undergoing extensive, ablative oncological surgery.
Interventions:
Simultaneous measurements of cardiac output by a new bioimpedance method and the standard thermodilution method during the intraoperative and immediate postoperative periods.
Measurements And Main Results:
The correlation coefficient between the two methods was r = 0.89, p < 0.001. Bias and precision analysis between the two techniques showed a mean bias of 0.1 L/min and SD of the bias [precision] of 1.0 L/min [95% level of agreement +2.1 L/min to -1.9 L/min]. After software enhancement, data from the last 11 monitored patients showed improved correlation between the two methods; r = 0.93, mean bias -0.1 L/min, and precision 0.8 L/min. Electrical and motion-induced interference only transiently impaired the performance of the new impedance method.
Conclusion:
This new impedance device is a safe, reliable, clinically acceptable alternative to the invasive thermodilution method in the operating room environment.