6533b872fe1ef96bd12d2fb9
RESEARCH PRODUCT
Comparison between doppler-echocardiography and uncalibrated pulse contour method for cardiac output measurement. a multicenter observational study
Sabino ScollettaFederico FranchiStefano RomagnoliRossella CarlàAbele DonatiLea P FabbriFrancesco ForforiJosé M Alonso-iñigoSilvia LaviolaValerio ManganiGiulia MajGiampaolo MartinelliLucia MirabellaAndrea MorelliPaolo PersonaDidier PayenOn Behalf Of Pulse Wave Analysis Cardiac Output Validation (Pulsecoval) GroupAlberto Zangrillosubject
Cardiac outputgenetic structuresintensive care unitsBlood PressureDoppler echocardiographyCritical Care and Intensive Care Medicinearterial waveform analysis; cardiac output; Doppler echocardiography; echocardiography; hemodynamic monitoring; pulse contour method; Critical Care and Intensive Care Medicinehemodynamic monitoring0302 clinical medicine030202 anesthesiologyechocardiographyhumansarterial waveform analysisarterial waveform analysis; cardiac output; doppler echocardiography; echocardiography; hemodynamic monitoring; pulse contour method; heart; humans; intensive care units; linear models; monitoring; physiologic; prospective studies; blood pressure; cardiac output; echocardiography; doppler; pulse; critical care and intensive care medicinemedicine.diagnostic_testPulse (signal processing)physiologicblood pressureHeartEchocardiography Dopplercardiovascular systemCardiologysymbolsLinear ModelDoppler effectHumandoppler echocardiographymedicine.medical_specialtyIntensive Care UnitLess invasiveheartpulse contour methoddoppler03 medical and health sciencesCardiac output measurementsymbols.namesakeInternal medicinemedicinePulsearterial waveform analysiMonitoring Physiologicbusiness.industrycardiac output030208 emergency & critical care medicineDoppler echocardiographyprospective studiesProspective StudiemonitoringMulticenter studycritical care and intensive care medicineObservational studylinear modelsbusinesspulsedescription
Objectives: Echocardiography and pulse contour methods allow, respectively, noninvasive and less invasive cardiac output estimation. The aim of the present study was to compare Doppler echocardiography with the pulse contour method MostCare for cardiac output estimation in a large and nonselected critically ill population. Design: A prospective multicenter observational comparison study. Setting: The study was conducted in 15 European medicosurgical ICUs. Patients: We assessed cardiac output in 400 patients in whom an echocardiographic evaluation was performed as a routine need or for cardiocirculatory assessment. Interventions: None. Measurements and Main Results: One echocardiographic cardiac output measurement was compared with the corresponding MostCare cardiac output value per patient, considering different ICU admission categories and clinical conditions. For statistical analysis, we used Bland-Altman and linear regression analyses. To assess heterogeneity in results of individual centers, Cochran Q, and the I 2 statistics were applied. A total of 400 paired echocardiographic cardiac output and MostCare cardiac output measures were compared. MostCare cardiac output values ranged from 1.95 to 9.90 L/min, and echocardiographic cardiac output ranged from 1.82 to 9.75 L/min. A significant correlation was found between echocardiographic cardiac output and MostCare cardiac output (r = 0.85; p < 0.0001). Among the different ICUs, the mean bias between echocardiographic cardiac output and MostCare cardiac output ranged from -0.40 to 0.45 L/min, and the percentage error ranged from 13.2% to 47.2%. Overall, the mean bias was -0.03 L/min, with 95% limits of agreement of -1.54 to 1.47 L/min and a relative percentage error of 30.1%. The percentage error was 24% in the sepsis category, 26% in the trauma category, 30% in the surgical category, and 33% in the medical admission category. The final overall percentage error was 27.3% with a 95% CI of 22.2-32.4%. Conclusions: Our results suggest that MostCare could be an alternative to echocardiography to assess cardiac output in ICU patients with a large spectrum of clinical conditions.
| year | journal | country | edition | language |
|---|---|---|---|---|
| 2016-01-01 |