J Clin Monit Comput - The impact of systemic vascular resistance on the accuracy of the FloTrac/Vigileo? system in the perioperative period of cardiac surgery: a prospective observational comparison study.

Tópicos

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Resumo

FloTrac/Vigileo? system is based on arterial pressure waveform analysis arterial pressure-based CO (APCO). Therefore, systemic vascular resistance (SVR) can influence the accuracy of APCO. The purpose of this study is to evaluate the relationship between SVR and the accuracy of APCO. We managed 50 consecutive patients in the perioperative period of cardiac surgery with FloTrac/Vigileo? system (v. 3.02) and Swan-Ganz catheter/Vigilance? system pulmonary artery catheter-based CO (PAC-CO) simultaneously. Continuous hemodynamic measurement using both methods was performed every 20?s from the induction of anesthesia to PAC removal 4?h after extubation. A total of 11,092 (intraoperative), 38,455 (postoperative, pre-extubation), and 44,235 (postoperative, post-extubation) data pairs were finally analyzed. Bland-Altman analysis revealed that in the intraoperative [postoperative pre-extubation, post-extubation] period, the bias was 0.5 [0.1, 0.0] L/min and the limits of agreement ranged from -2.4 to 3.3 [-2.2 to 2.4, -2.4 to 2.3] L/min. The percentage error was 60.3 [54.5, 48.5]?%. Regression analysis of the systemic vascular resistance index (SVRI) and the bias between APCO and PAC-CO showed that the bias was positively correlated to the SVRI. Subanalysis based on SVR with Lin's concordance correlation coefficient revealed that relatively satisfactory concordance was found in the normal-SVR group (concordance correlation coefficient c?=?0.51-0.56) regardless of vasoactive agent use. The accuracy of the FloTrac/Vigileo? System (v. 3.02) is relatively satisfactory in the condition with normal SVR regardless of vasoactive agent use. Positive correlation between the bias and SVR can be the clue to the more effective use of FloTrac/Vigileo? system.

Resumo Limpo

flotracvigileo system base arteri pressur waveform analysi arteri pressurebas co apco therefor system vascular resist svr can influenc accuraci apco purpos studi evalu relationship svr accuraci apco manag consecut patient periop period cardiac surgeri flotracvigileo system v swanganz cathetervigil system pulmonari arteri catheterbas co pacco simultan continu hemodynam measur use method perform everi s induct anesthesia pac remov h extub total intraop postop preextub postop postextub data pair final analyz blandaltman analysi reveal intraop postop preextub postextub period bias lmin limit agreement rang lmin percentag error regress analysi system vascular resist index svri bias apco pacco show bias posit correl svri subanalysi base svr lin concord correl coeffici reveal relat satisfactori concord found normalsvr group concord correl coeffici c regardless vasoact agent use accuraci flotracvigileo system v relat satisfactori condit normal svr regardless vasoact agent use posit correl bias svr can clue effect use flotracvigileo system

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