Disagreement between fourth generation FloTrac and LiDCOrapid measurements of cardiac output and stroke volume variation during laparoscopic colectomy - 18/04/17
: Specialist in Anesthesiology, Chief Anesthesiologist, Director, Aki Okutani, MD a : Staff Anesthesiologist, Taeko Miyata, MD a : Specialist in Anesthesiology, Norie Imanaka, MD a : Specialist in Anesthesiology, Masuji Tanaka, MD a : Specialist in Anesthesiology, Kae Nakasuji, MD a : Research fellow in Anesthesiology, Miwako Nagai, MD a : Staff AnesthesiologistAbstract |
Study objective |
To determine the agreement between cardiac output (CO) and stroke volume variation (SVV) measured simultaneously by the fourth generation FloTrac/Vigileo system and LiDCOrapid system during pneumoperitoneum in patients undergoing laparoscopic colectomy.
Design |
Retrospective observational study.
Settings |
Operating room in a general hospital.
Patients |
Ten patients (American Society of Anesthesiologist 1 or 2) without preoperative anemia.
Interventions |
A 22-gauge catheter was inserted in the radial artery after induction of anesthesia. The arterial line was split to monitor CO and SVV simultaneously with the LiDCOrapid and fourth generation FloTrac/Vigileo systems. All data were downloaded from each system after surgery and simultaneous paired COFloTrac, COLiDCO and SVVFloTrac, SVVLiDCO values estimated every 1 minute during the pneumoperitoneum were analyzed.
Measurements |
To assess the agreement after carbon dioxide insufflation, a scatter 4-quadrant plot was generated using paired ΔCO values (changes in COFloTrac and COLiDCO just before pneumoperitoneum and 3 minutes after the induction of pneumoperitoneum). For data in which SVVFloTrac was >9% but <16% and cardiac index measured by FloTrac/Vigileo was <2.5 L/min per m2 during stable pneumoperitoneum (the period from 5 minutes after Trendelenburg position until discontinuation of pneumoperitoneum), simultaneously measured paired SVVFloTrac and SVVLiDCO were plotted every 1 minute using the Bland-Altman method.
Main results |
A concordance ratio for changes in CO after the induction of pneumoperitoneum was 83% in 4-quadrant plot. During stable pneumoperitoneum, 702 paired SVVFloTrac and SVVLiDCO matched the criteria. These data sets were plotted by the Bland-Altman method and the bias and 95% limit of agreement of SVV were 2.01 and −2.63% to 6.65%, respectively, with 38% percentage error. The regression equation was SVVLiDCO = 0.98 × SVVFloTrac− 1.73 with Pearson correlation coefficient of 0.55.
Conclusions |
Our study showed disagreement between the 2 methods and the hemodynamic parameters measured by one of the two devices should be interpreted with caution before therapeutic interventions.
Le texte complet de cet article est disponible en PDF.Highlights |
• | The latest FloTrac and LiDCOrapid were compared during pneumoperitoneum. |
• | Cardiac output after induction of pneumoperitoneum disagreed with the 2 devices. |
• | Stroke volume variation during stable pneumoperitoneum also disagreed. |
• | The regression equation was SVVLiDCO = 0.98 × SVVFloTrac − 1.73. |
• | Parameters measured by one of the two devices should be interpreted with caution. |
Keywords : FloTrac/Vigileo, LiDCO, Pneumoperitoneum, Laparoscopic colectomy
Plan
| ☆ | Conflict of interest: The authors declare no conflicts of interest. |
Vol 35
P. 150-156 - décembre 2016 Retour au numéro
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