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The uncalibrated pulse contour cardiac output during off-pump coronary bypass surgery: performance in patients with a low cardiac output status and a reduced left ventricular function

Authors
 Youn Yi Jo  ;  Jong Wook Song  ;  Young Chul Yoo  ;  Ji Young Park  ;  Jae Kwang Shim  ;  Young Lan Kwak 
Citation
 KOREAN JOURNAL OF ANESTHESIOLOGY, Vol.60(4) : 237-243, 2011 
Journal Title
KOREAN JOURNAL OF ANESTHESIOLOGY
ISSN
 2005-6419 
Issue Date
2011
Keywords
Cardiac output ; Measurement techniques ; Off pump coronary artery bypass
Abstract
BACKGROUND: We compared the continuous cardiac index measured by the FloTrac/Vigileo™ system (FCI) to that measured by a pulmonary artery catheter (CCI) with emphasis on the accuracy of the FCI in patients with a decreased left ventricular ejection fraction (LVEF) and a low cardiac output status during off-pump coronary bypass surgery (OPCAB). We also assessed the influence of several factors affecting the pulse contour, such as the mean arterial pressure (MAP), the systemic vascular resistance index (SVRI) and the use of norepinephrine.

METHODS: Fifty patients who were undergoing OPCAB (30 patients with a LVEF ≥ 40%, 20 patients with a LVEF < 40%) were enrolled. The FCI and CCI were measured and we performed a Bland-Altman analysis. Subgroup analyses were done according to the LVEF (< 40%), the CCI (≤ 2.4 L/min/m), the MAP (60-80 mmHg), the SVRI (1,600-2,600 dyne/s/cm(5)/m(2)) and the use of norepinephrine.

RESULTS: The FCI was reliable at all the time points of measurement with an overall bias and limit of agreement of -0.07 and 0.67 L/min/m(2), respectively, resulting in a percentage error of 26.9%. The percentage errors in the patients with a decreased LVEF and in a low cardiac output status were 28.2% and 22.3%, respectively. However, the percentage error in the 91 data pairs outside the normal range of the SVRI was 40.2%.

CONCLUSIONS: The cardiac output measured by the FloTrac/Vigileo™ system was reliable even in patients with a decreased LVEF and in a low cardiac output status during OPCAB. Acceptable agreement was also noted during the period of heart displacement and grafting of the obtuse marginalis branch.
Files in This Item:
T201103179.pdf Download
DOI
10.4097/kjae.2011.60.4.237
Appears in Collections:
1. College of Medicine (의과대학) > Dept. of Anesthesiology and Pain Medicine (마취통증의학교실) > 1. Journal Papers
Yonsei Authors
Kwak, Young Lan(곽영란) ORCID logo https://orcid.org/0000-0002-2984-9927
Song, Jong Wook(송종욱) ORCID logo https://orcid.org/0000-0001-7518-2070
Shim, Jae Kwang(심재광) ORCID logo https://orcid.org/0000-0001-9093-9692
Yoo, Young Chul(유영철) ORCID logo https://orcid.org/0000-0002-6334-7541
URI
https://ir.ymlib.yonsei.ac.kr/handle/22282913/94011
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