Assessment of Trending Ability of Cardiac Output Monitors by Polar Plot Methodology

Critchley, Lester A. H.; Yang, Xian‐Wen; Lee, Anna

doi:10.1053/j.jvca.2011.01.003

Cited by 205 publications

(245 citation statements)

References 22 publications

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“…17 Trends were analyzed using polar plotting of CO changes among consecutive time points, as previously described. 18,19 A P value of \ 0.05 was considered to be statistically significant and all P values were two-tailed. Statistical analyses were performed using MedCalc Ò Software bvba version 12.5.0 (Mariakerke, Belgium) and Deltagraph Ò version 5.6 (RockWare Inc., Golden, CO, USA).…”

Section: Discussionmentioning

confidence: 99%

The diagnostic accuracy of estimated continuous cardiac output compared with transthoracic echocardiography

Fischer

Balaire

Kergal

et al. 2013

Can J Anesth/J Can Anesth

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Purpose Estimated continuous cardiac output (esCCO) is a new and noninvasive cardiac output (CO) monitoring device using pulse wave transit time. The aim of this study was to assess rapid changes in CO using esCCO (DCO esCCO ) without invasive calibration and to compare the results with those using transthoracic Doppler echocardiography (DCO TTE ). Methods Fifty-four consecutive patients were enrolled in this study following elective cardiac surgery. The CO esCCO and CO TTE were collected during four consecutive steps: 1) at baseline, 2) during passive leg raising (PLR), 3) at return to baseline, and 4) after a fluid challenge. The relationship between DCO esCCO and DCO TTE induced by PLR and a fluid challenge was assessed and a polar plot analysis was performed. Relationship, Bland-Altman analysis, and percentage error for absolute values of CO esCCO and CO TTE were also performed. Results Twenty-four patients were excluded from the analysis. No correlation was found between DCO esCCO and DCO TTE during PLR (r = 0.07; P = 0.732; n = 30) and after a fluid challenge (r = 0.24; P = 0.394; n = 14). The polar plot analysis showed that 21 data points (87%) of significant changes in CO were above the 30°radial sector lines and confirmed that esCCO was unable to track changes in CO. A weak positive relationship was found between absolute values of CO esCCO and CO TTE (r = 0.28; P = 0.004). Bias, precision, and limits of agreement were 0.25 LÁmin -1 , 2.4 LÁmin -1 , and -4.4 to 4.9 LÁmin -1 , respectively. The percentage error was 80%. Conclusions Estimated continuous cardiac output without external calibration seems unable to assess rapid changes in CO following cardiac surgery and was not interchangeable with transthoracic Doppler echocardiography.

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Section: Discussionmentioning

confidence: 99%

The diagnostic accuracy of estimated continuous cardiac output compared with transthoracic echocardiography

Fischer

Balaire

Kergal

et al. 2013

Can J Anesth/J Can Anesth

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“…The mean difference of the radial angle corresponds to the angular bias. An angular bias no greater than ± 5° and radial limits agreement no greater than ± 30° were defined to likely represent a good trending ability [22].…”

Section: Trending Abilitymentioning

confidence: 99%

Comparison of the ability of esCCO and Volume View to measure trends in cardiac output in patients undergoing cardiac surgery

Dache¹,

Rompaey²,

Joosten³

et al. 2017

Anaesthesiol Intensive Ther

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Background: Cardiac output (CO) is a physiological variable that should be monitored during cardiac surgery. The purpose of this study was to assess the trending ability of two CO monitors, esCCO (Nihon Kohden™, Tokyo, Japan) and Volume View (VV) (Edwards Lifesciences, Irvine, USA). Methods: A total of 19 patients were included in the study. Before cardiopulmonary bypass (CPB), CO was measured simultaneously using both esCCO and VV devices before and after three CO-modifying manoeuvres (passive leg raise [PLR], the end expiratory occlusion test [EEOT] and positive end expiratory pressure [PEEP] at 10 cm H 2 O). Five CO values for esCCO and three for VV were averaged and compared during a one-minute period of time before and after each manoeuvre. Results: A total of 114 paired readings were collected. Median CO values were 4.3 L min -1 (IQR: 3.8; 5.2) and 3.8 L min -1 (IQR: 3.5; 4.5) for esCCO and VV, respectively. The precision error was 1.4% (95% CI:1.0-1.7) for esCCO and 2.2% (95% CI: 1.8-2.7) for VV. The bias between esCCO and VV values was normally distributed (P = 0.0596). Between esCCO and VV, the mean bias was +0.6 L min -1 with a Limit of Agreement (LOA) of -1.8 L min -1 and +3.0 L min -1 . The concordance rate was 43% (95% CI: 29-58) between esCCO and VV. Conclusion: Both single and trended measurements of CO using esCCO and VV were not in agreement. This large discrepancy leads one to the conclusion that any outcome study conducted with one of these devices cannot be applied to the other.

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“…Для оценки способности системы esCCO отсле-живать тенденцию изменений СВ после вычисления разницы СВ (ΔСВ) между двумя последовательными измерениями для каждого метода (ΔСВ ВТПВ и ΔСВ ТПТД со-ответственно), путем вычитания значения на предшест-вующем этапе из значения на последующем, использова-ли полуполярную диаграмму [4]. Согласно рекомендации Critchley et al, из дальнейшего анализа исключили дан-ные центральной зоны полярной диаграммы со значени-ями ΔCO <0,5 л/мин, представляющими «статистический шум» [4].…”

Section: материал и методыunclassified

“…Согласно рекомендации Critchley et al, из дальнейшего анализа исключили дан-ные центральной зоны полярной диаграммы со значени-ями ΔCO <0,5 л/мин, представляющими «статистический шум» [4]. На основе данных полуполярной диаграммы рассчитывали угловую разницу, радиальные границы со-гласованности и полярную конкордантность.…”

Section: материал и методыunclassified

“…На основе данных полуполярной диаграммы рассчитывали угловую разницу, радиальные границы со-гласованности и полярную конкордантность. Способ-ность отслеживать динамику СВ считалась приемлемой при условии, что угловая разница была в пределах ± 5 °, радиальные границы согласованности -в пределах ± 30 ° и полярная конкордантность при радиальной границе в 30 ° составляла 95% и выше [4]. Результаты тестов счита-ли статистически значимыми при р <0,05.…”

Section: материал и методыunclassified

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Reliability of non-invasive cardiac output monitoring based on pulse wave transit time in off-pump coronary artery bypass grafting

Смёткин¹,

Хусcейн²,

Захаров³

et al. 2016

Patol krovoobrashch kardiokhir

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Aim: The study was designed to evaluate the accuracy of cardiac output (CO) measurements based on pulse wave transit time (PWTT) as compared to transpulmonary thermodilution (TPTD) in perioperative off-pump coronary artery bypass grafting (OPCABG). Methods: 20 patients scheduled for elective OPCABG were enrolled for a prospective study. Parallel measurements of CO by using PWTT (COPWTT) and TPTD (COTPTD) were carried out at five stages intraoperatively and at three stages postoperatively. Also analyzed was the agreement between CO absolute values and its ability to monitor cardiac output dynamics. Results: All in all, 153 pairs of CO data were obtained. According to Bland–Altman analysis, the mean intraoperative difference between the methods was 1.2 L/min, with boundaries of agreement reaching ± 2.9 L/min and a percentage error amounting to 64%. The intraoperative analysis of a polar plot revealed an increased angular difference of 6.9º and radial boundaries of agreement of ± 70.4º, and a decreased polar concordance rate (55%). The postoperative analysis of the data showed better agreement between the methods: mean difference was 0.4 L/min with boundaries of agreement of ± 2.3 L/min and percentage error of 41%. The postoperative trending ability was also more accurate (angular difference of 3.2º, angular boundaries of agreement ± 39º, polar concordance rate 81%). Conclusion: Poor accuracy and reproducibility of non-invasive COPWTT and its insufficient trending ability to monitor cardiac output during off-pump coronary artery bypass grafting makes it impossible to recommend this technology to be used intraoperatively as an alternative to transpulmonary thermodilution technique. The calibration and trending ability of COPWTT improved after OPCAB.

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Assessment of Trending Ability of Cardiac Output Monitors by Polar Plot Methodology

Cited by 205 publications

References 22 publications

The diagnostic accuracy of estimated continuous cardiac output compared with transthoracic echocardiography

The diagnostic accuracy of estimated continuous cardiac output compared with transthoracic echocardiography

Comparison of the ability of esCCO and Volume View to measure trends in cardiac output in patients undergoing cardiac surgery

Reliability of non-invasive cardiac output monitoring based on pulse wave transit time in off-pump coronary artery bypass grafting

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