Format

Send to

Choose Destination
J Cardiothorac Vasc Anesth. 2014 Dec;28(6):1521-6. doi: 10.1053/j.jvca.2014.04.013. Epub 2014 Oct 11.

Inaccuracy of the FloTrac/Vigileo™ system in patients with low cardiac index.

Author information

1
Department of Anesthesiology, National Cerebral and Cardiovascular Center, Osaka, Japan. Electronic address: takuma@ncvc.go.jp.
2
Department of Anesthesiology, National Cerebral and Cardiovascular Center, Osaka, Japan.

Abstract

OBJECTIVES:

The goal of this study was to compare cardiac output derived from the FloTrac/Vigileo™ system (CO(FT)) with cardiac output measured by 3-dimensional transesophageal echocardiography (CO3D) in patients with severe heart failure undergoing cardiac resynchronization therapy. The impact of preoperative systemic vascular resistance index on the accuracy of the FloTrac/Vigileo™ system also was investigated.

DESIGN:

Prospective clinical study.

SETTING:

Cardiac surgery operating room of a single cardiovascular center.

PARTICIPANTS:

Forty-one patients undergoing elective cardiac resynchronization therapy lead implantation.

INTERVENTIONS:

CO3D as the reference method and CO(FT) were determined simultaneously after induction of anesthesia.

MEASUREMENTS AND MAIN RESULTS:

Linear regression analysis showed a poor correlation between CO3D and CO(FT) (R² = 0.16). Bland-Altman plots showed wide limits of agreement between CO3D and CO(FT.). Bias was 0.60 ± 0.63 L/min with a high percentage error of 58.2%. Subgroup analysis showed that the percentage error between CO3D and CO(FT) was 74.1% in patients with a cardiac index<2.2 L/min/m(2) and 17.2% in patients with a cardiac index ≥ 2.2 L/min/m(2). Systemic vascular resistance index was significantly higher in patients with a cardiac index<2.2 L/min/m(2) (3,037 ± 820 v 2,461 ± 878; p = 0.039).

CONCLUSIONS:

The FloTrac/Vigileo™ system is not accurate in patients with low cardiac output, especially those with a cardiac index<2.2 L/min/m(2). A high systemic vascular resistance index in patients with low cardiac index may contribute to this inaccuracy.

KEYWORDS:

cardiac output; heart failure; intraoperative monitoring; low cardiac output syndrome; pulse-wave analysis; thermodilution

PMID:
25306519
DOI:
10.1053/j.jvca.2014.04.013
[Indexed for MEDLINE]

Supplemental Content

Full text links

Icon for Elsevier Science
Loading ...
Support Center