Comparison of continuous cardiac output monitoring derived from regional impedance cardiography with continuous thermodilution technique in cardiac surgical patients.

Publisher: Medknow Country of Publication: India NLM ID: 9815987 Publication Model: Print Cited Medium: Internet ISSN: 0974-5181 (Electronic) Linking ISSN: 09719784 NLM ISO Abbreviation: Ann Card Anaesth Subsets: MEDLINE

Publication: <2008-> : Mumbai : Medknow
Original Publication: [New Delhi : Indian Association of Cardiovascular Thoracic Anaesthesiologists

Cardiac Surgical Procedures*; Cardiac Output/*physiology ; Cardiography, Impedance/*methods ; Monitoring, Intraoperative/*methods; Adolescent ; Adult ; Aged ; Catheterization, Swan-Ganz ; Female ; Humans ; Male ; Middle Aged ; Prospective Studies ; Reproducibility of Results ; Thermodilution ; Young Adult

Background: Cardiac output (CO) assessment is a corner stone in advanced haemodynamic management, especially in critical ill patients. The present study was conducted to validate cardiac index and cardiac output by NICaS™ with the thermodilution technique using pulmonary artery catheter in post-operative cardiac surgical patients.
Materials and Methods: This was a prospective observational clinical study conducted at a tertiary care hospital. 23 adult patients in the age range of 18-65 years who had undergone for elective coronary artery bypass grafting were included in the study.
Results: Spearman's correlation coefficient of cardiac index between continuous Thermodilution (cTD) and Non-Invasive Cardiac System (NICaS™) showed a good correlation (r = 0.765, 95% confidence interval 0.70 to 0.82, P < 0.0001). There was a good correlation between cTD and NICaS™ for cardiac output (r = 0.759, 95% confidence interval 0.69 to 0.81, P < 0.0001), Bland-Altman plot for cardiac index between cTD and NICaS™ showed a mean bias of -0.66 ± 0.6919 with limits of agreement being -2.02 to 0.6936. Bland-Altman plot for cardiac output between cTD and NICaS™ showed a mean bias of -1.0386 ± 1.17 with limits of agreement being -3.34 to + 1.26. Percentage error for cardiac index and cardiac output were 64.78% and 64% respectively. Polar plot analysis showed an angular bias of 6.32° with radial limits of agreement being -8.114° to 20.75° for cardiac index and angular bias of 5.6682° with radial limits of agreement being -9.1422° to 20.4784° for cardiac output.
Conclusion: NICaS™ demonstrated a good trending ability for both CI and CO. However, NICaS™ derived parameters are not interchangeable with the values derived from continuous thermodilution technique.
Competing Interests: None

Chest. 2004 Apr;125(4):1431-40. (PMID: 15078756)
Anesth Analg. 2010 Nov;111(5):1180-92. (PMID: 20736431)
BMJ. 2005 Mar 5;330(7490):506-10. (PMID: 15746131)
BMC Pregnancy Childbirth. 2018 Jun 14;18(1):229. (PMID: 29898711)
J Thorac Cardiovasc Surg. 2010 Oct;140(4):790-6. (PMID: 20152992)
Crit Care Med. 2007 May;35(5):1296-301. (PMID: 17414091)
N Engl J Med. 2013 Oct 31;369(18):1726-34. (PMID: 24171518)
Endocr J. 2014;61(6):571-5. (PMID: 24621777)
Hemodial Int. 2018 Apr;22(2):201-208. (PMID: 28796425)
Circulation. 2005 Aug 30;112(9 Suppl):I448-52. (PMID: 16159861)

Keywords: Cardiac index; NICaS™; cardiac output; continuous thermodilution technique

Date Created: 20200411 Date Completed: 20210316 Latest Revision: 20210316

20221213

PMC7336960

10.4103/aca.ACA_1_19

32275034