FloTrac for monitoring arterial pressure and cardiac output during phaeochromocytoma surgery

Collange, Olivier; Xavier, Lorenço; Kuntzman, H.; Calon, B.; Schaeffer, Richard C.; Pottecher, T.; Diemunsch, Pierre; Pessaux, Patrick

doi:10.1017/s0265021508004432

Cited by 7 publications

(7 citation statements)

References 11 publications

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“…However, our results do not take into account data from recent case reports questioning the ability of FloTrac to accurately track cardiac output during dramatic intraoperative changes in hemodynamics. 101,102 In 1999, Critchley and Critchley reviewed 25 studies comparing TEB and esophageal Doppler with thermodilution. 89 In an unweighted pooling of the data from these studies, they found a mean percentage error of 37% for TEB and 65% for esophageal Doppler.…”

Section: Discussionmentioning

confidence: 99%

Minimally Invasive Measurement of Cardiac Output during Surgery and Critical Care

2010

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Section: Discussionmentioning

confidence: 99%

Minimally Invasive Measurement of Cardiac Output during Surgery and Critical Care

2010

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“…Another pathophysiological The FloTrac™-derived value of APCO, which is calculated based on analysis of the peripheral arterial pressure waveform without external calibration, has theoretically a more rapid response than PACO. At the same time, however, APCO is vulnerable to changes in vascular resistance or artifacts, and there can be discordance between PACO and APCO, which have different algorithms [8,10]. PACO requires more than 6 min to display the cardiac output on the monitor, and the subsequent value updates the average value every 7 min for every minute.…”

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

“…The use of a pulmonary artery catheter, which directly monitors cardiac output, contributes to the accurate estimation of the cardiovascular status [7,8]. Alternatively, a less-invasive method for monitoring cardiac output based on the waveform of arterial blood pressure (ABP) has been introduced for clinical use [8]. In patients undergoing orthotopic liver transplantation, who could develop hyperdynamic circulation and low systemic vascular resistance, the arterial pressure-based cardiac output (APCO) had poor agreement with the pulmonary artery catheter-based cardiac output (PACO) during general anesthesia [9].…”

Section: Introductionmentioning

confidence: 99%

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Intraoperative hemodynamics monitoring in a patient with pheochromocytoma multisystem crisis: a case report

et al. 2018

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Background: Pheochromocytoma is a rare catecholamine-secreting tumor. To evaluate the intraoperative hemodynamics with precision is difficult. Case presentation: A 42-year-old man, who suddenly developed a life-threatening pheochromocytoma multisystem crisis that occurred during preoperative prophylactic medication, underwent urgent bilateral adrenalectomy. For the purpose of evaluating the intraoperative hemodynamics, we monitored both pulmonary artery catheter-based cardiac output (PACO) and arterial pressure-based cardiac output (APCO; FloTrac™). APCO fluctuated in poor agreement with the change in PACO, especially in the state of cytokine storming. Conclusions: Overall, the value of stroke volume variation derived from FloTrac™ changed in tandem with the intraoperative volume status, indicating its utility as a marker of circulatory hemodynamics.

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“…However, in a study looking at haemodynamically unstable patients, the accuracy of FT compared with transpulmonary thermodilution was unacceptably poor (percentage error 58.8%) 10 . Observations from clinicians also highlight the potential for poor performance of arterial pressure derived CO devices in challenging clinical situations with changing haemodynamics 11,12 .…”

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confidence: 99%

A Comparison of Three Minimally Invasive Cardiac Output Devices with Thermodilution in Elective Cardiac Surgery

Phan

Kluger

Wan

et al. 2011

Anaesth Intensive Care

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This study compared the cardiac output responses to haemodynamic interventions as measured by three minimally invasive monitors (Oesophageal Doppler Monitor, the VigileoFlotrac and the LiDCOrapid) to the responses measured concurrently using thermodilution, in cardiac surgical patients. The study also assessed the precision and bias of these monitors in relation to thermodilution measurements. After a fluid bolus of at least 250 ml, the measured change in cardiac output was different among the devices, showing an increase with thermodilution in 82% of measurements, Oesophageal Doppler Monitor 68%, VigileoFlotrac 57% and LiDCOrapid 41%. When comparing the test devices to thermodilution, the kappa statistic showed at best only fair agreement, Oesophageal Doppler Monitor 0.34, LiDCOrapid 0.28 and VigileoFlotrac-0.03. After vasopressor administration, there was also significant variation in the change in cardiac output measured by the devices. Using Bland-Altman analysis, the precision of the devices in comparison to thermodilution showed minimal bias, but wide limits of agreement with percentage errors of Oesophageal Doppler Monitor 64.5%, VigileoFlotrac 47.6% and LiDCOrapid 54.2%. These findings indicate that these three devices differ in their responses, do not always provide the same information as thermodilution and should not be used interchangeably to track cardiac output changes.

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FloTrac for monitoring arterial pressure and cardiac output during phaeochromocytoma surgery

Cited by 7 publications

References 11 publications

Minimally Invasive Measurement of Cardiac Output during Surgery and Critical Care

Minimally Invasive Measurement of Cardiac Output during Surgery and Critical Care

Intraoperative hemodynamics monitoring in a patient with pheochromocytoma multisystem crisis: a case report

A Comparison of Three Minimally Invasive Cardiac Output Devices with Thermodilution in Elective Cardiac Surgery

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