• Evgeniia V Fot, Alexey A Smetkin, Dmitriy A Volkov, Tatyana N Semenkova, Konstantin V Paromov, Vsevolod V Kuzkov, and Mikhail Y Kirov.
• Department of Anesthesiology and Intensive Care Medicine, Northern State Medical University, Arkhangelsk, Russia; Department of Anesthesiology and Intensive Care Medicine, City Hospital #1 n.a. E.E. Volosevich, Arkhangelsk, Russia. Electronic address: ev_fot@mail.ru.
• J. Cardiothorac. Vasc. Anesth. 2023 Jun 1; 37 (6): 919926919-926.

ObjectiveTo compare the reliability of cardiac index (CI) and stroke-volume variation (SVV) measured by the pulse-wave transit-time (PWTT) method using estimated continuous cardiac output (esCCO) technique with conventional pulse-contour analysis after off-pump coronary artery bypass grafting (OPCAB).DesignA single-center, prospective, observational study.SettingAt a 1,000-bed university hospital.ParticipantsA total of 21 patients were enrolled after elective OPCAB.InterventionsThe study authors performed a method comparison study with simultaneous measurement of CI and SVV based on the esCCO technique (CIesCCO and esSVV, correspondingly) and pulse-contour analysis (CIPCA and SVVPCA, correspondingly). As a secondary analysis, they also assessed the trending ability of CIesCCO versus CIPCA. MEASUREMENTS AND MAIN RESULTS: The authors analyzed 178 measurement pairs for CI, and 174 pairs for SVV during the 10 study stages. The mean bias between CIesCCO and CIPCA was 0.06 L min/m2, with limits of agreement of ± 0.92 L min/m2 and a percentage error (PE) of 35.3%. The analysis of the trending ability of CI measured by PWTT revealed a concordance rate of 70%. The mean bias between esSVV and SVVPCA was -6.1%, with limits of agreement of ± 15.5% and a PE of 137%.ConclusionsThe overall performance of CIesCCO and esSVV versus CIPCA and SVVPCA is not clinically acceptable. A further improvement of the PWTT algorithm may be required for an accurate and precise assessment of CI and SVV.Copyright © 2023 Elsevier Inc. All rights reserved.

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