Hagen Maxeiner1, Sibylle Wenzel2, Markus A. Weigand1, Matthias Mueller1
1Dep. Anesthesiology, Intensive Care Medicine and Pain Therapy, University Hospital Gießen and Marburg, Location Gießen, Germany; 2Department of Physiology, Justus-Liebig-University Gießen, Germany
[Applied Cardiopulmonary Pathophysiology 14: 131-138, 2010]
Background: Determination of cardiac output by the classic thermodilution technique is widely accepted to be the gold standard, but it is not without additional risks due to invasive catheterisation. Therefore, we compared it with the less invasive FloTracTM/VigileoTM-system based on an automated pulse contour analysis.
Methods: 34 patients who underwent cardiac surgery with extracorporal circulation were included. In each patient, four measurements were performed. A software update split the patients into two groups: 19 of them were measured using software version V1.07, 15 were measured using software version V1.10.
Results: Overall, 120 measurements were performed. Software version V1.07 showed a bias of -0.45l•(min•m2)-1 and a precision of 0.53l•(min•m2)-1. The percentage error was 45%. Software version V1.10 showed a bias of -0.26l•(min•m2)-1 and a precision of 0.42l•(min•m2)-1, the percentage error was 36% in this case. The differences were statistically significant with respect to the bias but not to the precision.
Conclusion: Although software version V1.10 led to an improvement in the concordance with thermodilution technique, the percentage error exceeds the acceptable threshold of 28.28%. Therefore, in the setting of cardiac surgery the FloTracTM/VigileoTM-system cannot replace the thermodilution technique at present.
Key words: pulmonary artery catheter, thermodilution, cardiac output, pulse contor analysis, semi-invasive
Hagen Maxeiner, M.D.
Dept. Anesthesiology, Intensive Care Medicine and Pain Therapy
University Hospital Gießen and Marburg