Assessment of cardiac output changes using a modified FloTrac/Vigileo™ algorithm in cardiac surgery patients

Senn, A; Button, D.; Zollinger, Andreas; Hofer, Christoph K.

doi:10.1186/cc7739

Cited by 61 publications

(35 citation statements)

References 23 publications

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“…A specific patient-calibration factor (cal) (which is independent of compliance and resistance) is added to the formula, which computes the pulse-contour cardiac output [7]. This estimation of cardiac output from the pulse-contour analysis has been demonstrated as reliable by numerous studies in various clinical settings [4-8,13,32,34-37]. …”

Section: Discussionmentioning

confidence: 99%

Arterial pressure-based cardiac output in septic patients: different accuracy of pulse contour and uncalibrated pressure waveform devices

et al. 2010

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IntroductionWe compared the ability of two devices estimating cardiac output from arterial pressure-curve analysis to track the changes in cardiac output measured with transpulmonary thermodilution induced by volume expansion and norepinephrine in sepsis patients.MethodsIn 80 patients with septic circulatory failure, we administered volume expansion (40 patients) or introduced/increased norepinephrine (40 patients). We measured the pulse contour-derived cardiac index (CI) provided by the PiCCO device (CIpc), the arterial pressure waveform-derived CI provided by the Vigileo device (CIpw), and the transpulmonary thermodilution CI (CItd) before and after therapeutic interventions.ResultsThe changes in CIpc accurately tracked the changes in CItd induced by volume expansion (bias, -0.20 ± 0.63 L/min/m2) as well as by norepinephrine (bias, -0.05 ± 0.74 L/min/m2). The changes in CIpc accurately detected an increase in CItd ≥ 15% induced by volume expansion and norepinephrine introduction/increase (area under ROC curves, 0.878 (0.736 to 0.960) and 0.924 (0.795 to 0.983), respectively; P < 0.05 versus 0.500 for both). The changes in CIpw were less reliable for tracking the volume-induced changes in CItd (bias, -0.23 ± 0.95 L/min/m2) and norepinephrine-induced changes in CItd (bias, -0.01 ± 1.75 L/min/m2). The changes in CIpw were unable to detect an increase in CItd ≥ 15% induced by volume expansion and norepinephrine introduction/increase (area under ROC curves, 0.564 (0.398 to 0.720) and 0.541 (0.377 to 0.700, respectively, both not significantly different from versus 0.500).ConclusionsThe CIpc was reliable and accurate for assessing the CI changes induced by volume expansion and norepinephrine. By contrast, the CIpw poorly tracked the trends in CI induced by those therapeutic interventions.

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Section: Discussionmentioning

confidence: 99%

Arterial pressure-based cardiac output in septic patients: different accuracy of pulse contour and uncalibrated pressure waveform devices

et al. 2010

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“…However, based on the results of the early validation studies, a major modification of the algorithm (generation 2 software) was a reduction of this time window to 1 min [11•]. Studies using this modified algorithm showed improved CO estimation [12][13][14]. Newer software modifications (generation 3) addressing the issue of limited accuracy during hyperdynamic situations (eg, severe sepsis or septic shock) are currently being tested.…”

Section: Flotrac/vigileo Systemmentioning

confidence: 98%

Minimally Invasive Monitoring of Cardiac Output in the Cardiac Surgery Intensive Care Unit

Alhashemi

Cecconi

Rocca

et al. 2010

Curr Heart Fail Rep

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Cardiac output monitoring in the cardiac surgery patient is standard practice that is traditionally performed using the pulmonary artery catheter. However, over the past 20 years, the value of pulmonary artery catheters has been challenged, with some authors suggesting that its use might be not only unnecessary but also harmful. New minimally invasive devices that measure cardiac output have become available. In this paper, we review their operative principles, limitations, and utility in an integrated approach that could potentially change patients' outcome. However, it is now clear that it is how the monitor is used (ie, the protocol or therapy associated with its use, or its lack thereof), and not the monitor per se, that should be questioned when a patient's outcome is being evaluated.

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“…The second generation software (1.07 or later) was designed to perform a self-calibration every minute. The third generation software (3.0 or later) which uses a dynamic tone technology and more physiological variables demonstrated an improved accuracy in cardiac surgical patients [48], in liver transplant [49] and in general surgery [50]. Because of the unreliability of the third generation software to track the changes in CI with vasopressors administration [51] the fourth generation software (version 4.00) was developed based on a new correction factor for acute changes in SVR.…”

Section: Flotrac/vigileo (Edwards Lifesciences -Usa)mentioning

confidence: 99%

Pulse waveform hemodynamic monitoring devices: recent advances and the place in goal-directed therapy in cardiac surgical patients

Hendy

Bubenek

2016

Rom J Anaesth Int Care

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Hemodynamic monitoring has evolved and improved greatly during the past decades as the medical approach has shifted from a static to a functional approach. The technological advances have led to innovating calibrated or not, but minimally invasive and noninvasive devices based on arterial pressure waveform (APW) analysis. This systematic clinical review outlines the physiologic rationale behind these recent technologies. We describe the strengths and the limitations of each method in terms of accuracy and precision of measuring the flow parameters (stroke volume, cardiac output) and dynamic parameters which predict the fluid responsiveness. We also analyzed the place of the APW monitoring devices in goaldirected therapy (GDT) protocols in cardiac surgical patients. According to the data from the three GDTrandomized control trials performed in cardiac surgery (using two types of APW techniques PiCCO and FloTrac/Vigileo), these devices did not demonstrate that they played a role in decreasing mortality, but only decreasing the ventilation time and the ICU and hospital length of stay.

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Assessment of cardiac output changes using a modified FloTrac/Vigileo™ algorithm in cardiac surgery patients

Cited by 61 publications

References 23 publications

Arterial pressure-based cardiac output in septic patients: different accuracy of pulse contour and uncalibrated pressure waveform devices

Arterial pressure-based cardiac output in septic patients: different accuracy of pulse contour and uncalibrated pressure waveform devices

Minimally Invasive Monitoring of Cardiac Output in the Cardiac Surgery Intensive Care Unit

Pulse waveform hemodynamic monitoring devices: recent advances and the place in goal-directed therapy in cardiac surgical patients

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