Improved Performance of the Fourth-Generation FloTrac/Vigileo System for Tracking Cardiac Output Changes.

Journal of cardiothoracic and vascular anesthesia

PubMedID: 25440654

Suehiro K, Tanaka K, Mikawa M, Uchihara Y, Matsuyama T, Matsuura T, Funao T, Yamada T, Mori T, Nishikawa K. Improved Performance of the Fourth-Generation FloTrac/Vigileo System for Tracking Cardiac Output Changes. J Cardiothorac Vasc Anesth. 2014;.
OBJECTIVES
The aims of this study were to compare cardiac output (CO) measured by the new fourth-generation FloTrac(TM)/Vigileo(TM) system (Version 4.00) (COFVS) with that measured by a pulmonary artery catheter (COREF), and to investigate the ability of COFVS to track CO changes induced by increased peripheral resistance.

DESIGN
Prospective study.

SETTING
University Hospital.

PARTICIPANTS
Twenty-three patients undergoing cardiac surgery.

INTERVENTIONS
Phenylephrine (100 µg) was administered.

MEASUREMENTS AND MAIN RESULTS
Hemodynamic variables, including COREF and COFVS, were measured before and after phenylephrine administration. Bland-Altman analysis was used to assess the discrepancy between COREF and COFVS. Four-quadrant plot and polar-plot analyses were utilized to evaluate the trending ability of COFVS against COREF after phenylephrine boluses. One hundred thirty-six hemodynamic interventions were performed. The bias shown by the Bland-Altman analysis was-0.66 L/min, and the percentage error was 55.4%. The bias was significantly correlated with the systemic vascular resistance index (SVRI) before phenylephrine administration (p<0.001, r(2) = 0.420). The concordance rate determined by four-quadrant plot analysis and the angular concordance rate calculated using polar-plot analysis were 87.0% and 83.0%, respectively. Additionally, this trending ability was not affected by SVRI state.

CONCLUSIONS
The trending ability of the new fourth-generation FloTrac(TM)/Vigileo(TM) system after increased vasomotor tone was greatly improved compared with previous versions; however, the discrepancy of the new system in CO measurement was not clinically acceptable, as in previous versions. For clinical application in critically ill patients, this vasomotor tone-dependent disagreement must be decreased.