Evaluation of pulse wave transit time analysis for non-invasive cardiac output quantification in pregnant patients

Abstract

Pregnant patients undergoing minimally-invasive foetoscopic surgery for foetal spina bifida have a need to be subjected to advanced haemodynamic monitoring. this observational study compares cardiac output as measured by transpulmonary thermodilution monitoring with the results of non-invasive estimated continuous cardiac output monitoring. transpulmonary thermodilution-based pulse contour analysis was performed for usual anaesthetic care, while non-invasive estimated continuous cardiac output monitoring data were additionally recorded. Thirty-five patients were enrolled, resulting in 199 measurement time points. cardiac output measurements of the non-invasive estimated continuous cardiac output monitoring showed a weak correlation with the corresponding thermodilution measurements (correlation coefficient: 0.44, R 2 : 0.19; non-invasive estimated continuous cardiac output: 7.4 [6.2-8.1]; thermodilution cardiac output: 8.9 [7.8-9.8]; p ≤ 0.001), while cardiac index experienced no such correlation. Furthermore, neither stroke volume nor stroke volume index correlated with the corresponding thermodilution-based data. even though non-invasive estimated continuous cardiac output monitoring consistently underestimated the corresponding thermodilution parameters, no trend analysis was achievable. Summarizing, we cannot suggest the use of non-invasive estimated continuous cardiac output monitoring as an alternative to transpulmonary thermodilution for cardiac output monitoring in pregnant patients undergoing minimally-invasive foetoscopic surgery for spina bifida.

Effect of Pulse Indicator Continuous Cardiac Output Monitoring on Septic Shock Patients: A Meta-Analysis

“…The study of Schneck et al showed that for SS patients with myocardial injury, PICCO-guided fluid resuscitation can reduce the occurrence of fluid overload, reduce the degree of organ dysfunction, and shorten the duration of mechanical ventilation and ICU stay [ 58 ]. CVP is used as an indicator to evaluate the state of vascular volume because of its simplicity, but some studies have shown that CVP is not significantly correlated with blood volume [ 59 , 60 ].…”

Factors Associated with Variability in Pulse Wave Transit Time Using Pulse Oximetry: A Retrospective Study

“…Further, PWTT fluctuations can be observed noninvasively using conventional vital sign measurements. PWTT measurement remains a potential simple and affordable alternative to systemic vascular resistance measurements in patients with systemic diseases who receive dental treatment [ 33 ].…”

Lung-to-finger circulation time can be measured stably with high reproducibility by simple breath holding method in cardiac patients

“…Pulse wave transit time analysis method and bioimpedance method are also suggested non-invasive CO measurement methods. But pulse wave transit time was reported a poor correlation with CO measured by a standard method in significantly reduced vascular resistance condition 8 . Bioreactance method was also affected by lung injuries and fluid accumulation within the thorax 32 other than actual CO changes.…”

“…Cardiac MRI 2 Volume clamp method 5 Impedance cardiography 6 Bioreactance method 7 Pulse wave transit time analysis 8 Inert gas rebreathing technique 9 Procedure for LFCT measurement and data exclusion criteria. Patients were asked to lay down, and an air-flow sensor (TR-101A, Nihon Kohden Corp., Tokyo, Japan) was set on the nose.…”