The Validation of Cardiac Index and Stroke-Volume Variation Measured by the Pulse-Wave Transit Time-Analysis Versus Conventional Pulse-Contour Analysis After Off-Pump Coronary Artery Bypass Grafting: Observational Study

Fot, Evgenia V.; Smetkin, A.; Volkov, D.; Semenkova, Tatyana N.; Paromov, K.V.; Kuzkov, Vsevolod V.; Kirov, Mikhail Y.

doi:10.1053/j.jvca.2023.02.010

Cited by 3 publications

(5 citation statements)

References 23 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…As reported by Meng et al [ 17 ] Flotrac/Vigileo TM exhibits different accuracy when using phenylephrine and ephedrine, which promote different changes in peripheral vascular resistance. Pulse-counter methods such as Flotrac/Vigileo TM use blood pressure waveforms.…”

Section: Discussionmentioning

confidence: 82%

See 1 more Smart Citation

Comparative evaluation of stroke volume variation measured by pulse wave transit time and arterial pressure wave

Ochiai

Terada²,

Sakamoto

2024

THC

View full text Add to dashboard Cite

BACKGROUND: Several monitors have been developed that measure stroke volume (SV) in a beat-to-beat manner. Accordingly, Stroke volume variation (SVV) induced by positive pressure ventilation is widely used to predict fluid responsiveness. OBJECTIVE: The purpose of this study was to compare the ability of two different methods to predict fluid responsiveness using SVV, stroke volume variation by esCCO (esSVV) and stroke volume variation by FloTrac/VigileoTM (flSVV). METHODS: esSVV, flSVV, and stroke volume index (SVI) by both monitoring devices of 37 adult patients who underwent laparotomy surgery, were measured. Receiver operating characteristic (ROC) analysis was performed. RESULTS: The area under the ROC curve (AUC) of esSVV was significantly higher than that of flSVV (p= 0.030). esSVV and flSVV showed cutoff values of 6.1% and 10% respectively, to predict an increase of more than 10% in SVI after fluid challenge. The Youden index for esSVV was higher than flSVV, even with a cutoff value between 6% and 8%. CONCLUSION: Since esSVV and flSVV showed significant differences in AUC and cutoff values, the two systems were not comparable in predicting fluid responsiveness. Furthermore, it seems that SVV needs to be personalized to accurately predict fluid responsiveness for each patient.

show abstract

Section: Discussionmentioning

confidence: 82%

“…Indeed, in our previous study, PWTT-derived cardiac output monitoring showed better accuracy, precision, and trending ability than arterial pressure cardiac output monitoring [ 15 ]. However, each method to measure SV has been criticized [ 16 , 17 , 18 ].…”

Section: Introductionmentioning

confidence: 99%

Comparative evaluation of stroke volume variation measured by pulse wave transit time and arterial pressure wave

Ochiai

Terada²,

Sakamoto

2024

THC

View full text Add to dashboard Cite

show abstract

“…Previous work has primarily looked at PAT in the context of adult trials as it was known to have a good correlation with stroke volume (Sugo et al 2010 ). An observational study by Fot et al ( 2023 ), examined a commercial product (esCCO) in 21 adults undergoing elective off pump coronary artery bypass, that utilizes a strategy analogous to PAT. In addition to using non-invasive waveform data, esCCO utilizes a proprietary corrective formula to better predict CO in adults.…”

Section: Discussionmentioning

confidence: 99%

“…PiCCO provides an excellent assessment for continuous CI, but requires placement of invasive venous catheters (Aslan et al 2020 ). Trademarked brands, such as VISMO®, provide estimated continuous CO (esCCO) based on ECG, pulse-oximeter wave, and cuff arterial BP; however, acceptable performance for clinical application is questionable (Terada et al 2014 , Anand et al 2021 , Fot et al 2023 ). Impedance cardiography has gained attraction as a non-invasive modality to measure CI; however, this methodology requires additional electrodes, and the measured signals can be disrupted by respirations and patient movement (Nederend et al 2017 ).…”

Section: Introductionmentioning

confidence: 99%

Non-invasive pulse arrival time is associated with cardiac index in pediatric heart transplant patients with normal ejection fraction

Kwon,

Weinerman,

Nametz

et al. 2024

Physiol. Meas.

View full text Add to dashboard Cite

Objective: Cardiac Index (CI) is a key physiologic parameter to ensure end organ perfusion in the pediatric intensive care unit (PICU). Determination of CI requires invasive cardiac measurements and is not routinely done at the PICU bedside. To date, there is no gold standard non-invasive means to determine CI. This study aims to use a novel non-invasive methodology, based on routine continuous physiologic data, called Pulse Arrival Time (PAT) as a surrogate for CI in patients with normal Ejection Fraction. Approach: Electrocardiogram (ECG) and photoplethysmogram (PPG) signals were collected from beside monitors at a sampling frequency of 250 samples per second. Continuous PAT, derived from the ECG and PPG waveforms was averaged per patient. Pearson’s correlation coefficient was calculated between PAT and CI, PAT and heart rate (HR), and PAT and ejection fraction (EF). Main Results: Twenty patients underwent right heart cardiac catheterization. The mean age of patients was 11.7±5.4 years old, ranging from 11 months old to 19 years old, the median age was 13.4 years old. HR in this cohort was 93.8±17.0 beats per minute. The average EF was 54.4±9.6%. The average CI was 3.51±0.72 L/min/m2, with ranging from 2.6 to 4.77 L/min/m2. The average PAT was 0.31±0.12 seconds. Pearson correlation analysis showed a positive correlation between PAT and CI (0.57, p < 0.01). Pearson correlation between HR and CI, and correlation between EF and CI was 0.22 (p = 0.35) and 0.03 (p = 0.23) respectively. The correlation between PAT, when indexed by HR (i.e. PAT × HR), and CI minimally improved to 0.58 (p < 0.01).Significance: This pilot study demonstrates that PAT may serve as a valuable surrogate marker for CI at the bedside, as a non-invasive and continuous modality in the PICU. The use of PAT in clinical practice remains to be thoroughly investigated. 

show abstract

“…Pulse wave transit time (PWTT) systems provide CO based on the time it takes for a pulse pressure waveform to travel between two sites of capture, typically the electrocardiogram and pulse oximetry. Despite being both inexpensive and noninvasive, recent studies, including those respective to cardiac surgery, have shown variable concordance with more conventional methods [56 ▪ ,57,58]. Finally, devices that utilize bioimpedance and/or bioreactance rely upon assessment of electrical resistance in the blood stream that accompany changes in fluid volume.…”

Section: Introductionmentioning

confidence: 99%

Perioperative hemodynamic monitoring in cardiac surgery

Grant,

Salenger,

Lobdell

2023

Current Opinion in Anaesthesiology

View full text Add to dashboard Cite

Purpose of review Cardiac surgery has traditionally relied upon invasive hemodynamic monitoring, including regular use of pulmonary artery catheters. More recently, there has been advancement in our understanding as well as broader adoption of less invasive alternatives. This review serves as an outline of the key perioperative hemodynamic monitoring options for cardiac surgery. Recent findings Recent study has revealed that the use of invasive monitoring such as pulmonary artery catheters or transesophageal echocardiography in low-risk patients undergoing low-risk cardiac surgery is of questionable benefit. Lesser invasive approaches such a pulse contour analysis or ultrasound may provide a useful alternative to assess patient hemodynamics and guide resuscitation therapy. A number of recent studies have been published to support broader indication for these evolving technologies. Summary More selective use of indwelling catheters for cardiac surgery has coincided with greater application of less invasive alternatives. Understanding the advantages and limitations of each tool allows the bedside clinician to identify which hemodynamic monitoring modality is most suitable for which patient.

show abstract

The Validation of Cardiac Index and Stroke-Volume Variation Measured by the Pulse-Wave Transit Time-Analysis Versus Conventional Pulse-Contour Analysis After Off-Pump Coronary Artery Bypass Grafting: Observational Study

Cited by 3 publications

References 23 publications

Comparative evaluation of stroke volume variation measured by pulse wave transit time and arterial pressure wave

Comparative evaluation of stroke volume variation measured by pulse wave transit time and arterial pressure wave

Non-invasive pulse arrival time is associated with cardiac index in pediatric heart transplant patients with normal ejection fraction

Perioperative hemodynamic monitoring in cardiac surgery

Contact Info

Product

Resources

About