• Christoph K Hofer, Danny Button, Luc Weibel, Michele Genoni, and Andreas Zollinger.
• Institute of Anesthesiology and Intensive Care Medicine, Triemli City Hospital, Zurich, Switzerland. christoph.hofer@triemli.stzh.ch
• J. Cardiothorac. Vasc. Anesth. 2010 Apr 1;24(2):257-64.

ObjectivesArterial pressure waveform analysis is a less invasive alternative to the pulmonary artery catheter for continuous cardiac output (CO) measurement. Uncalibrated and calibrated systems are actually available (ie, the FloTrac/Vigileo system [Edwards Lifesciences, Irvine, CA] and the PiCCOplus system [Pulsion Medical Systems, Munich, Germany]). According to the FloTrac/Vigileo manufacturer, reliable measurements can be performed using any existing arterial catheter. The aim of this study was to evaluate CO determined by the FloTrac/Vigileo system using a radial (FCO(radial)) and femoral arterial catheter (FCO(femoral)) as well as the PiCCOplus system (PCO). Intermittent pulmonary artery thermodilution (ICO) was used as primary reference technique.DesignA prospective clinical study.SettingA teaching hospital, single center.ParticipantsTwenty-six cardiac surgery patients.InterventionsPerioperative CO measurements.Measurements And Main ResultsCO was assessed at predefined measurement points. FCO(radial), FCO(femoral), and PCO were recorded after the induction of anesthesia, after sternotomy, at skin closure, after intensive care unit transfer, and during intensive care unit stay 12 and 24 hours after study initiation. ICO was determined as the mean of 3 bolus injections. Bland-Altman analysis revealed comparable mean bias and limits of agreement for FCO(radial), FCO(femoral), and PCO when compared with ICO. There was a decreased agreement for all devices in the postoperative period. However, a consistently close agreement was observed for the direct comparison between FCO(radial) and FCO(femoral).ConclusionsPerformance of the FloTrac/Vigileo system via radial as well as femoral access and the PiCCOplus monitoring for cardiac output measurement were comparable when tested against intermittent thermodilution in cardiac surgery patients.Copyright (c) 2010 Elsevier Inc. All rights reserved.

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