Comparison of Cardiac Output Measurement by Noninvasive Method with Electrical Cardiometry and Invasive Method with Thermodilution Technique in Patients Undergoing Coronary Artery Bypass GraftingReportar como inadecuado




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Objective: This study was conducted to compare the cardiac output by using Electrical Cardiometry EC, a noninvasive method of continuous cardiac output monitoring during cardiac surgery with pulmonary artery catheter PAC derived cardiac output. Design: Prospective observational clinical study. Setting: Cardiac surgery operating room of a tertiary care cardiac center. Participants: Twenty five patients undergoing coronary artery bypass surgery with cardiopulmonary bypass. Measurements and Main Results: A total of 150 double data of cardiac output were compared with Thermodilution Cardiac Output TDCO and Thoracic Electrical Bioimpedance TEBCO. The TDCO value ranges from 1.8-6.9 litre·min-1 with a mean of 4.39 ± 1.16 litre·min-1 and TEBCO ranges from 1.8-7.1 litre·min-1 with a mean of 4.21 ± 1.16 litre·min-1. The averaged Bland-Altman analysis for TDCO and TEBCO revealed that a mean bias was 0.18 and limit of agreement was -1.25 - 0.89 litre·min-1 and the percentage error PE ranged from 22%-32%. The precision for the TDCO was measured to be ±16.2% and the precision for TEBCO was ±19.6%. Receiver Operating Characteristic ROC curve analysis between TDCO and TEBCO with a cutoff of 15% shows a sensitivity of 84% and specificity of 63 and area under ROC curve of 0.80. Mountain plot between TDCO and TEBCO shows that a median percentile is 0.25 and value of 97.5 percentile is 1.525. Conclusions: The present study indicates that the electric cardiometry device yields numerically comparable results to cardiac outputs derived from the PAC during the cardiac surgery. Therefore, electrical cardiometry can be used to evaluate haemodynamic variables with clinically acceptable accuracy, when invasive methods are to be avoided or not available.

KEYWORDS

Electric Cardiometry, Thermodilution, Pulmonary Artery Catheter, Non Invasive Cardiac Output, Thoracic Electrical Bioimpedance

Cite this paper

Rajput, R. , Das, S. , Chauhan, S. , Bisoi, A. and Vasdev, S. 2014 Comparison of Cardiac Output Measurement by Noninvasive Method with Electrical Cardiometry and Invasive Method with Thermodilution Technique in Patients Undergoing Coronary Artery Bypass Grafting. World Journal of Cardiovascular Surgery, 4, 123-130. doi: 10.4236-wjcs.2014.47019.





Autor: Randhir Singh Rajput, Sambhunath Das, Sandeep Chauhan, A. K. Bisoi, Sumit Vasdev

Fuente: http://www.scirp.org/



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