Accuracy and Trending Ability of Blood Pressure and Cardiac Index Measured by ClearSight System in Patients With Reduced Ejection Fraction

Kanazawa, Hiroko; Maeda, Takuma; Miyazaki, Erika; Hotta, Naoshi; Ito, Shinya; Ohnishi, Yoshihiko

doi:10.1053/j.jvca.2020.03.045

Cited by 9 publications

(10 citation statements)

References 22 publications

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“…In this study, we did not provide instructions for the administration of vasoactive drugs or inotropic agents but observed the ability of ClearSight to follow trends before and after TAVI. The time points for comparison were every few tens of seconds in previous studies, but every few tens of minutes in this study, which was more gradual than in previous studies [ 13 , 21 , 22 ]. However, in the present study, the rate of agreement after prosthetic valve deployment according to the four-quadrant plot analysis was 60.3%, which was much lower than the cutoff value for acceptable trending ability (92%) [ 17 ].…”

Section: Discussionmentioning

confidence: 67%

“…The cutoff for inaccurate CO ClearSight measurements has been reported in previous studies to be a cardiac index < 2.5 (L/min/m 2 ). In this study, 60 (53%) datasets had a cardiac index < 2.5, which may have contributed to the discrepancy between the CO measurement methods [ 21 , 22 ]. We predicted that CO would increase after AS was released during TAVI, and the accuracy of the ClearSight would be within acceptable limits at T3 and T4.…”

Section: Discussionmentioning

confidence: 99%

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Noninvasive cardiac output measurements are inaccurate in patients with severe aortic valve stenosis undergoing transcatheter aortic valve implantation

Yahagi

Omi

Tabata

et al. 2022

Korean J Anesthesiol

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Background: Noninvasive cardiac output (CO) measured using ClearSight™ eliminates the need for intra-arterial catheter insertion. The purpose of this study was to examine the accuracy of non-invasive CO measurement in patients with severe aortic valve stenosis (AS). Methods: Twenty-eight patients undergoing elective transcatheter aortic valve implantation were prospectively enrolled in this study. The CO was simultaneously measured twice before and twice after valve deployment (total of four times) per patient, and the CO was compared between the ClearSight (COClearSight) system and the pulmonary artery catheter (PAC) thermodilution (COTD) method as a reference. The Bland-Altman analysis was used to compare the percentage errors between the methods. Results: A total of 112 paired data points were obtained. The percentage error between the COClearSight and COTD was 43.1%. The paired datasets were divided into the following groups according to the systemic vascular resistance index (SVRI): low (< 1,200 dyne s/cm5/m2) and normal (1,200–2,500 dyne s/cm5/m2). The percentage errors were 44.9% and 49.4%, respectively. The discrepancy of CO between COClearSight and COTD was not significantly correlated with SVRI (r = −0.06, P < 0.001). The polar plot analysis showed the trending ability of the COClearSight after artificial valve deployment was 51.1% which below the acceptable cut-off (92%). Conclusions: The accuracy and the trending ability of the ClearSight CO measurements were not acceptable in patients with severe AS. Therefore, the ClearSight system is not interchangeable with the PAC thermodilution for determining CO in this population.

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Section: Discussionmentioning

confidence: 67%

Section: Discussionmentioning

confidence: 99%

Noninvasive cardiac output measurements are inaccurate in patients with severe aortic valve stenosis undergoing transcatheter aortic valve implantation

Yahagi

Omi

Tabata

et al. 2022

Korean J Anesthesiol

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“…However, the potential utility of this device is not confined solely to TAVR patients. Previous research has indicated the potential benefits of this device in other types of cardiovascular surgeries [8,24,25]. Hence, its accuracy and reliability may extend to broader surgical contexts and patient characteristics.…”

Section: Discussionmentioning

confidence: 99%

Comparison of direct intra-arterial pressure and ClearSight finger cuff arterial pressure measurements in elderly patients undergoing transcatheter aortic valve replacement

Yahagi,

Sasaki

2023

Blood Pressure Monitoring

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Objective: This study aimed to assess the agreement between direct intra-arterial pressure and ClearSight finger cuff arterial pressure measurements in elderly patients undergoing transcatheter aortic valve replacement (TAVR). Methods: A prospective observational study was conducted at Hitachi General Hospital, Japan, involving 30 patients aged 65 years and older who underwent TAVR under general anesthesia. Intra-arterial pressure and finger cuff arterial pressure measurements were recorded for 30 min after valve deployment. Bland–Altman analysis, four-quadrant plot analysis, and error grid analysis were used to assess the concordance between the two methods. Multiple regression analysis was performed to explore potential confounding factors affecting the agreement. Results: The bias and precision of ClearSight measurements were −4.88 ± 15.46 (mmHg) for SBP, 4.73 ± 8.95 (mmHg) for mean, and 9.53 ± 9.01 (mmHg) for DBP. The Bland–Altman analysis demonstrated acceptable agreement between intra-arterial pressure and finger cuff arterial pressure measurements. The four-quadrant plot analysis showed good trend-tracking ability, and the error grid analysis revealed that most of the observed values fell into the no-risk category. The mean BP match ratio and SBP match ratio were influenced by several factors such as age, BSA, ejection fraction, valve size, and gender. Conclusion: The ClearSight finger cuff arterial pressure measurement showed good agreement with direct intra-arterial pressure in elderly patients undergoing TAVR. However, factors such as age, BSA, ejection fraction, valve size, and gender may influence the agreement between the two methods.

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“…Based on previous studies on the accuracy of ClearSight™-derived CI in other surgeries [ 24 , 25 ], we aimed to recruit a total of 30 patients, assuming a 10% dropout rate.…”

Section: Discussionmentioning

confidence: 99%

Comparison of invasive and non-invasive measurements of cardiac index and systemic vascular resistance in living-donor liver transplantation: a prospective, observational study

Cho,

Lee,

Hwang

et al. 2023

BMC Anesthesiol

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Background Based on the controversy surrounding pulmonary artery catheterization (PAC) in surgical patients, we investigated the interchangeability of cardiac index (CI) and systemic vascular resistance (SVR) measurements between ClearSight™ and PAC during living-donor liver transplantation (LDLT). Methods This prospective study included consecutively selected LDLT patients. ClearSight™-based CI and SVR measurements were compared with those from PAC at seven LDLT-stage time points. ClearSight™-based systolic (SAP), mean (MAP), and diastolic (DAP) arterial pressures were also compared with those from femoral arterial catheterization (FAC). For the comparison and analysis of ClearSight™ and the reference method, Bland-Altman analysis was used to analyze accuracy while polar and four-quadrant plots were used to analyze the trending ability. Results From 27 patients, 189 pairs of ClearSight™ and reference values were analyzed. The CI and SVR performance errors (PEs) exhibited poor accuracy between the two methods (51.52 and 51.73%, respectively) in the Bland-Altman analysis. CI and SVR also exhibited unacceptable trending abilities in both the polar and four-quadrant plot analyses. SAP, MAP, and DAP PEs between the two methods displayed favorable accuracy (24.28, 21.18, and 26.26%, respectively). SAP and MAP exhibited acceptable trending ability in the four-quadrant plot between the two methods, but not in the polar plot analyses. Conclusions During LDLT, CI and SVR demonstrated poor interchangeability, while SAP and MAP exhibited acceptable interchangeability between ClearSight™ and FAC.

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Accuracy and Trending Ability of Blood Pressure and Cardiac Index Measured by ClearSight System in Patients With Reduced Ejection Fraction

Cited by 9 publications

References 22 publications

Noninvasive cardiac output measurements are inaccurate in patients with severe aortic valve stenosis undergoing transcatheter aortic valve implantation

Noninvasive cardiac output measurements are inaccurate in patients with severe aortic valve stenosis undergoing transcatheter aortic valve implantation

Comparison of direct intra-arterial pressure and ClearSight finger cuff arterial pressure measurements in elderly patients undergoing transcatheter aortic valve replacement

Comparison of invasive and non-invasive measurements of cardiac index and systemic vascular resistance in living-donor liver transplantation: a prospective, observational study

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