TY - JOUR
T1 - Accuracy of arterial pressure waveform analysis for cardiac output measurement in comparison with thermodilution methods in patients undergoing living donor liver transplantation
AU - Akiyoshi, Kozaburo
AU - Kandabashi, Tadashi
AU - Kaji, Junko
AU - Yamaura, Ken
AU - Yoshimura, Hayashi
AU - Irita, Kazuo
AU - Hoka, Sumio
N1 - Funding Information:
Edwards Lifesciences Japan Ltd. provided monitoring instruments that were used throughout this evaluation. We received financial support from Edwards Lifesciences Japan Ltd. to carry out this study.
PY - 2011/4
Y1 - 2011/4
N2 - Purpose The aim of this study was to assess the accuracy of the first and third versions of arterial pressure waveform ardiac output (APCOv.1.0 and APCOv.3.0) measurements in comparison with thermodilution methods in patients undergoing living donor liver transplantation. Methods Twenty patients were anesthetized and mechanically ventilated. A radial arterial line was connected to a dedicated transducer for the APCO evaluation (FloTracTM). A pulmonary artery catheter was placed and connected to a computer system (VigilanceTM) to measure intermittent thermodilution cardiac output (COTD) and continuous cardiac output (CCO). Results A total of 138 measurements were analyzed. Bland-Altman analysis showed that the mean biases for COTD-APCOv.3.0, CO TD-APCOv.1.0, and COTD-CCO were 0.89, 1.73, and -0.79 L/min, and the adjusted percentage errors were 37.5, 30.3, and 43%, respectively. While the variance for COTD-APCOv.3.0 was greater, the accuracy bias) improved by 0.8 L/min as compared with CO TD-APCOv.1.0. The difference COTD-APCO v.3.0 became apparent when systemic vascular resistance was lower than 1000 dyne 9 s/cm5 , especially below 700 dyne 9 s/cm 5. Conclusion These data suggest that the accuracy of APCO v.3.0 has improved compared to APCOv.1.0 due to the updated algorithm, but additional improvements should be evaluated, especially in patients undergoing living donor liver transplantation with low systemic vascular resistance.
AB - Purpose The aim of this study was to assess the accuracy of the first and third versions of arterial pressure waveform ardiac output (APCOv.1.0 and APCOv.3.0) measurements in comparison with thermodilution methods in patients undergoing living donor liver transplantation. Methods Twenty patients were anesthetized and mechanically ventilated. A radial arterial line was connected to a dedicated transducer for the APCO evaluation (FloTracTM). A pulmonary artery catheter was placed and connected to a computer system (VigilanceTM) to measure intermittent thermodilution cardiac output (COTD) and continuous cardiac output (CCO). Results A total of 138 measurements were analyzed. Bland-Altman analysis showed that the mean biases for COTD-APCOv.3.0, CO TD-APCOv.1.0, and COTD-CCO were 0.89, 1.73, and -0.79 L/min, and the adjusted percentage errors were 37.5, 30.3, and 43%, respectively. While the variance for COTD-APCOv.3.0 was greater, the accuracy bias) improved by 0.8 L/min as compared with CO TD-APCOv.1.0. The difference COTD-APCO v.3.0 became apparent when systemic vascular resistance was lower than 1000 dyne 9 s/cm5 , especially below 700 dyne 9 s/cm 5. Conclusion These data suggest that the accuracy of APCO v.3.0 has improved compared to APCOv.1.0 due to the updated algorithm, but additional improvements should be evaluated, especially in patients undergoing living donor liver transplantation with low systemic vascular resistance.
UR - http://www.scopus.com/inward/record.url?scp=79959963936&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=79959963936&partnerID=8YFLogxK
U2 - 10.1007/s00540-010-1087-y
DO - 10.1007/s00540-010-1087-y
M3 - Article
C2 - 21246221
AN - SCOPUS:79959963936
SN - 0913-8668
VL - 25
SP - 178
EP - 183
JO - Journal of Anesthesia
JF - Journal of Anesthesia
IS - 2
ER -