FloTrac/vigileo™ (third generation) and mostcare®/PRAM versus echocardiography for cardiac output estimation in vascular surgery

Stefano Romagnoli, Zaccaria Ricci, Salvatore M. Romano, Fabio Dimizio, Eleonora Bonicolini, Diego Quattrone, Raffaele De Gaudio

Research output: Contribution to journalArticle

Abstract

Objective To compare the FloTrac/Vigileo™ cardiac output (CO FT/V) and the MostCare®/PRAM cardiac output (COMC/P) versus transthoracic echocardiographic cardiac output estimation (reference method; COECHO). Design Prospective observational study. Setting Single center, Cardio-Thoracic and Vascular Surgery/Intensive Care Unit. Participants Patients undergoing elective vascular surgery. Interventions Cardiac output measurement with two pulse contour methods: the FloTrac/Vigileo™ and the MostCare®/PRAM before (T1) and after (T2) fluid loading versus echocardiography (reference method). Measurements and Main Results One hundred fifty-six CO measurements were performed in 26 patients. The data showed poor agreement between COECHO and COFT/V: r2 = 0.29 (T1) and 0.27 (T2); bias -0.37 (T1) and -0.40 (T2) L/min; limits of agreement from -3.10 to 2.42 (T1) and from -3.0 to 2.2 (T2) L/min. The percentage error was 51.7% (T1) and 49.3% (T2). Conversely, COMC/P resulted in agreement with echocardiography: r2 = 0.76 (T1) and 0.80 (T2); bias -0.01 (T1) and -0.06 (T2) L/min; limits of agreement from -1.13 to 1.11 (T1) and from -0.90 to 0.80 (T2) L/min, with a PE of 22.4% (T1) and of 17.0% (T2). Conclusions In patients undergoing vascular surgery, the FloTrac/Vigileo™ did not demonstrate that it was a reliable system for CO monitoring when compared with echocardiography-derived CO. However, MostCare®/PRAM was shown to estimate CO with a good level of agreement with echocardiographic measures.

Original languageEnglish
Pages (from-to)1114-1121
Number of pages8
JournalJournal of Cardiothoracic and Vascular Anesthesia
Volume27
Issue number6
DOIs
Publication statusPublished - Dec 2013

Keywords

  • cardiac output
  • cardiac output monitors
  • FloTrac
  • goal-directed therapy
  • MostCare
  • PRAM
  • pulse contour methods
  • vascular surgery
  • Vigileo

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine
  • Anesthesiology and Pain Medicine

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