Comparison of electrical velocimetry and transthoracic thermodilution technique for cardiac output assessment in critically ill patients

Raue, W.; Swierzy, Marc; Koplin, Gerold; Schwenk, W.

doi:10.1097/eja.0b013e32832bfd94

Cited by 33 publications

(23 citation statements)

References 30 publications

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“…Those full-text articles were assessed for eligibility, which led to 24 included studies and 17 excluded studies [18,[52][53][54][55][56][57][58][59][60][61][62][63][64][65][66][67]. The included studies were divided into 13 studies in adults [28][29][30][31][32][33][34][35][36][37][38][39][40] and 11 studies in pediatrics [41][42][43][44][45][46][47][48][49][50][51]. Contacting the manufacturer and screening of the reference lists of all included studies led to no additional studies.…”

Section: Study Selectionmentioning

confidence: 99%

“…Sample size ranged from 16 to 134 patients with a mean of 52 patients. Concerning adult studies; two were conducted in the OR during liver transplantation surgery [31,39], three during cardiac surgery [28,29,36], two both during cardiac surgery and post cardiac surgery in the ICU [30,33], two in the ICU [35,40], three in the cardiology unit [34,37,38] and one in the outpatient unit [32]. Concerning pediatric studies; four were conducted in the OR [45,47,49,50], two in the ICU [43,44], two in the neonatal intensive care unit (NICU) [46,51], and three in the outpatient unit [41,42,48].…”

Section: Study Characteristicsmentioning

confidence: 99%

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Accuracy and precision of non-invasive cardiac output monitoring by electrical cardiometry: a systematic review and meta-analysis

Sanders

Servaas

Slagt

2019

J Clin Monit Comput

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Cardiac output monitoring is used in critically ill and high-risk surgical patients. Intermittent pulmonary artery thermodilution and transpulmonary thermodilution, considered the gold standard, are invasive and linked to complications. Therefore, many non-invasive cardiac output devices have been developed and studied. One of those is electrical cardiometry. The results of validation studies are conflicting, which emphasize the need for definitive validation of accuracy and precision. We performed a database search of PubMed, Embase, Web of Science and the Cochrane Library of Clinical Trials to identify studies comparing cardiac output measurement by electrical cardiometry and a reference method. Pooled bias, limits of agreement (LoA) and mean percentage error (MPE) were calculated using a random-effects model. A pooled MPE of less than 30% was considered clinically acceptable. A total of 13 studies in adults (620 patients) and 11 studies in pediatrics (603 patients) were included. For adults, pooled bias was 0.03 L min −1 [95% CI − 0.23; 0.29], LoA − 2.78 to 2.84 L min −1 and MPE 48.0%. For pediatrics, pooled bias was − 0.02 L min −1 [95% CI − 0.09; 0.05], LoA − 1.22 to 1.18 L min −1 and MPE 42.0%. Inter-study heterogeneity was high for both adults (I 2 = 93%, p < 0.0001) and pediatrics (I 2 = 86%, p < 0.0001). Despite the low bias for both adults and pediatrics, the MPE was not clinically acceptable. Electrical cardiometry cannot replace thermodilution and transthoracic echocardiography for the measurement of absolute cardiac output values. Future research should explore it's clinical use and indications.

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Section: Study Selectionmentioning

confidence: 99%

Section: Study Characteristicsmentioning

confidence: 99%

Accuracy and precision of non-invasive cardiac output monitoring by electrical cardiometry: a systematic review and meta-analysis

Sanders

Servaas

Slagt

2019

J Clin Monit Comput

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“…[74][75][76]. Variance in electric skin conductivity between the body and the electrodes including temperature and humidity [77,78], patient movement and lack of clinician attention to exact placement of sticker-electrodes and electric noise may contribute to inaccurate and variables measurements reading [77,79,80].…”

Section: Thoracic Electrical Bioimpedancementioning

confidence: 99%

Guiding Goal-Directed Therapy

Suehiro

Joosten

Alexander

2014

Curr Anesthesiol Rep

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Several studies have demonstrated that perioperative hemodynamic optimization (or ''goal directed therapy'') using minimally invasive hemodynamic monitoring technologies has the ability to improve postoperative patients' outcome with lower complication rates, shorter hospital lengths of stay, and lower cost of surgery. This specific concept of goal-directed therapy (GDT) uses perioperative cardiac output monitoring and manipulation of physiologic parameters (dynamic parameters of fluid responsiveness) to guide intravenous fluids and inotropic therapy with the goal of ensuring adequate tissue perfusion. Recently, the evidence related to the implementation of GDT strategies has been considered strong enough to allow for the creation of national recommendations in the UK, in France, and by the European Society of Anaesthesiology. The aims of the programs are to apply best practices to high-risk surgical patients and requires the participation of all clinicians involved in patients' care. Considering the potential clinical and economic benefits of GDT protocols and the positive recommendations from influential scientific societies, more and more hospitals around the world have become interested in implementing hemodynamic optimization in their departments. This review provides the information about the evolution of hemodynamic monitoring from invasive to the more recent noninvasive devices, and how these devices can be used in the operating rooms through well-defined algorithms of GDT.

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“…The mean percentage error of EV was only acceptable before skin incision (sternotomy), but thereafter the mean percentage error of all pairs of measurements was greater than ±30%. In addition, two new studies from 2009 (Tomaske et al, 2009); (Raue et al, 2009) further question the reliability of the Aesculon Ò monitor, because the method did not reliably reflect absolute CO values, when compared to sub-xiphoidal Doppler flow measurements in children with congenital heart defects, and because the agreement between EV and transthoracic TD was poor in adult patients with severe systemic inflammatory response syndrome or sepsis.…”

Section: Measurements Of Cardiac Output At Restmentioning

confidence: 99%

Measurement of cardiac output with non-invasive Aesculon® impedance versus thermodilution

Petter

Erik

Ekmehag

et al. 2010

Clinical Physiology and Functional Imaging

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Comparison of electrical velocimetry and transthoracic thermodilution technique for cardiac output assessment in critically ill patients

Abstract: There was poor agreement between the values of cardiac output estimation by transthoracic thermodilution and those by electrical velocimetry. Electrical velocimetry could not replace invasive monitoring in this trial.

Cited by 33 publications

References 30 publications

Accuracy and precision of non-invasive cardiac output monitoring by electrical cardiometry: a systematic review and meta-analysis

Accuracy and precision of non-invasive cardiac output monitoring by electrical cardiometry: a systematic review and meta-analysis

Guiding Goal-Directed Therapy

Measurement of cardiac output with non-invasive Aesculon® impedance versus thermodilution

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