Improved Performance of the Fourth-Generation FloTrac/Vigileo System for Tracking Cardiac Output Changes.
Koichi Suehiro
Katsuaki Tanaka
Mika Mikawa
Yuriko Uchihara
Taiki Matsuyama
Tadashi Matsuura
Tomoharu Funao
Tokuhiro Yamada
Takashi Mori
Kiyonobu Nishikawa
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.
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