Dataset Information

Comparing Cardiac Output Measurements Using a Wearable, Wireless, Noninvasive Photoplethysmography-Based Device to Pulse Contour Cardiac Output in the General ICU: A Brief Report.

ABSTRACT:

Objectives

Cardiac output (CO) measurements in the ICU are usually based on invasive techniques, which are technically complex and associated with clinical complications. This study aimed to compare CO measurements obtained from a noninvasive photoplethysmography-based device to a pulse contour cardiac output device in ICU patients.

Design

Observational, prospective, comparative clinical trial.

Setting

Single-center general ICU.

Patients

Patients admitted to the general ICU monitored using a pulse contour cardiac output device as per the decision of the attending physician.

Interventions

Parallel monitoring of CO using a photoplethysmography-based chest patch device and pulse contour cardiac output while the medical team was blinded to the values obtained by the noninvasive device.

Measurements and main results

Seven patients (69 measurements) were included in the final analysis. Mean CO were 7.3 ± 2.0 L/m and 7.0 ± 1.5 L/m for thermodilution and photoplethysmography, respectively. Bland-Altman showed that the photoplethysmography has a bias of 0.3 L/m with -1.6 and 2.2 L/m 95% limit of agreement (LOA) and a bias of 2.4% with 95% LOA between -25.7% and 30.5% when calculating the percentage of difference from thermodilution. The values obtained by thermodilution and photoplethysmography were highly correlated (r = 0.906).

Conclusions

The tested chest patch device offers a high accuracy for CO compared to data obtained by the pulse contour cardiac output and the thermodilution method in ICU patients. Such devices could offer advanced monitoring capabilities in a variety of clinical settings, without the complications of invasive devices.

SUBMITTER: Dvir A

PROVIDER: S-EPMC8812679 | biostudies-literature | 2022 Feb

REPOSITORIES: biostudies-literature

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Publications

Comparing Cardiac Output Measurements Using a Wearable, Wireless, Noninvasive Photoplethysmography-Based Device to Pulse Contour Cardiac Output in the General ICU: A Brief Report.

Dvir Ayana A Goldstein Nir N Rapoport Avigal A Balmor Ronen Gingy RG Nachman Dean D Merin Roei R Fons Meir M Ben Ishay Arik A Eisenkraft Arik A

Critical care explorations 20220201 2

<h4>Objectives</h4>Cardiac output (CO) measurements in the ICU are usually based on invasive techniques, which are technically complex and associated with clinical complications. This study aimed to compare CO measurements obtained from a noninvasive photoplethysmography-based device to a pulse contour cardiac output device in ICU patients.<h4>Design</h4>Observational, prospective, comparative clinical trial.<h4>Setting</h4>Single-center general ICU.<h4>Patients</h4>Patients admitted to the gene ...[more]

PMID: 35128457

Similar Datasets

Project description:Cardiac output measurement with pulse contour analysis is a continuous, mini-invasive, operator-independent, widely used, and cost-effective technique, which could be helpful to assess changes in cardiac output. The 4-quadrant plot and the polar plot have been described to compare the changes between 2 measurements performed under different conditions, and the direction of change by using different methods of measurements. However, the 4-quadrant plot and the polar plot present a number of limitations, with a risk of misinterpretation in routine clinical practice. We describe a new trend interchangeability method designed to objectively define the interchangeability of each change of a variable. Using the repeatability of the reference method, we classified each change as either uninterpretable or interpretable and then as either noninterchangeable, in the gray zone or interchangeable. An interchangeability rate can then be calculated by the number of interchangeable changes divided by the total number of interpretable changes. In this observational study, we used this objective method to assess cardiac output changes with 5 arterial pulse contour techniques (Wesseling's method, LiDCO, PiCCO, Hemac method, and Modelflow) in comparison with bolus thermodilution technique as reference method in 24 cardiac surgery patients. A total of 172 cardiac output variations were available from the 199 data points: 88 (51%) were uninterpretable, according to the first step of the method. The second step of the method, based on the 84 (49%) interpretable variations, showed that only 18 (21%) to 30 (36%) variations were interchangeable regardless of the technique used. None of pulse contour cardiac output technique could be interchangeable with bolus thermodilution to assess changes in cardiac output using the trend interchangeability method in cardiac surgery patients. Future studies may consider using this method to assess interchangeability of changes between different methods of measurements.

Project description:BackgroundPatients scheduled for thoracic cancer surgery are eligible for goal-directed fluid therapy, but cardiac output monitoring remains challenging in that specific setting.ObjectiveWe aimed to compare cardiac output as measured with chest bioreactance with that measured by calibrated pulse contour analysis; the hypothesis being that both methods would be interchangeable.DesignA prospective monocentre observational study.SettingA tertiary university hospital.PatientsFifty adult patients undergoing thoracic cancer surgery over a one year period.Main outcome measuresSimultaneous measurements of cardiac index (CI) with bioreactance (CI-NICOM) and arterial pulse contour analysis calibrated by transthoracic echocardiography (CI-PCA) were performed at eight pre-specified intra-operative time points and following fluid challenge and/or vasoactive agents. Relationships between absolute values and changes in CI were assessed by linear regression. Interchangeability was tested with Bland-Altman analysis and percentage error calculation. A four quadrant plot was used to evaluate trending ability.ResultsThere was a significant difference between CI-PCA and CI-NICOM: 2.4 ± 0.8 (range: 0.9 to 5.8) l min-1 m-2 vs. 2.9 ± 0.9 (range: 0.9 to 7.2) l min-1 m-2, respectively (P < 0.001). A positive relationship was found between both techniques: y = 0.29x + 2.19; r 2 = 0.08 (P < 0.001). Taking CI-PCA as the reference method, there was a systematic overestimation of CI-NICOM by 21% (0.5 l min-1 m-2) and limits of agreement were large: -2.49 to 1.47 l min-1 m-2. The percentage error was 77% and concordance rates were 75 and 70% with and without an exclusion zone of 0.5 l min-1 m-2.ConclusionChest bioreactance is feasible and well tolerated in patients undergoing thoracic surgery for cancer. When compared with calibrated PCA over a wide range of CI values, the technique is moderately correlated, not interchangeable, and provides moderate trending ability.Trial registrationNCT04251637.

Dataset Information

Comparing Cardiac Output Measurements Using a Wearable, Wireless, Noninvasive Photoplethysmography-Based Device to Pulse Contour Cardiac Output in the General ICU: A Brief Report.

Objectives

Design

Setting

Patients

Interventions

Measurements and main results

Conclusions

Publications

Comparing Cardiac Output Measurements Using a Wearable, Wireless, Noninvasive Photoplethysmography-Based Device to Pulse Contour Cardiac Output in the General ICU: A Brief Report.

Similar Datasets

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