J Clin Monit Comput - An autocalibrating algorithm for non-invasive cardiac output determination based on the analysis of an arterial pressure waveform recorded with radial artery applanation tonometry: a proof of concept pilot analysis.


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We aimed to describe and evaluate an autocalibrating algorithm for determination of cardiac output (CO) based on the analysis of an arterial pressure (AP) waveform recorded using radial artery applanation tonometry (AT) in a continuous non-invasive manner. To exemplarily describe and evaluate the CO algorithm, we deliberately selected 22 intensive care unit patients with impeccable AP waveforms from a database including AP data obtained with AT (T-Line system; Tensys Medical Inc.). When recording AP data for this prospectively maintained database, we had simultaneously noted CO measurements obtained from just calibrated pulse contour analysis (PiCCO system; Pulsion Medical Systems) every minute. We applied the autocalibrating CO algorithm to the AT-derived AP waveforms and noted the computed CO values every minute during a total of 15 min of data recording per patient (3 ? 5-min intervals). These 330 AT-derived CO (AT-CO) values were then statistically compared to the corresponding pulse contour CO (PC-CO) values. Mean ? standard deviation for PC-CO and AT-CO was 7.0 ? 2.0 and 6.9 ? 2.1 L/min, respectively. The coefficient of variation for PC-CO and AT-CO was 0.280 and 0.299, respectively. Bland-Altman analysis demonstrated a bias of +0.1 L/min (standard deviation 0.8 L/min; 95% limits of agreement -1.5 to 1.7 L/min, percentage error 23%). CO can be computed based on the analysis of the AP waveform recorded with AT. In the selected patients included in this pilot analysis, a percentage error of 23% indicates clinically acceptable agreement between AT-CO and PC-CO.

Resumo Limpo

aim describ evalu autocalibr algorithm determin cardiac output co base analysi arteri pressur ap waveform record use radial arteri applan tonometri continu noninvas manner exemplarili describ evalu co algorithm deliber select intens care unit patient impecc ap waveform databas includ ap data obtain tline system tensi medic inc record ap data prospect maintain databas simultan note co measur obtain just calibr puls contour analysi picco system pulsion medic system everi minut appli autocalibr co algorithm atderiv ap waveform note comput co valu everi minut total min data record per patient min interv atderiv co atco valu statist compar correspond puls contour co pcco valu mean standard deviat pcco atco lmin respect coeffici variat pcco atco respect blandaltman analysi demonstr bias lmin standard deviat lmin limit agreement lmin percentag error co can comput base analysi ap waveform record select patient includ pilot analysi percentag error indic clinic accept agreement atco pcco

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