• J. Cardiothorac. Vasc. Anesth. · Jul 2024

    Reliability of Bioreactance and Pulse-Power Analysis in Measuring Cardiac Index During Open Abdominal Aortic Surgery.

    • Heikki Pekka Oskari Ronkainen, Laura Anneli Ylikauma, Mari Johanna Pohjola, Pasi Petteri Ohtonen, Tiina Maria Erkinaro, Merja Annika Vakkala, Janne Henrik Liisanantti, Tatu Sakari Juvonen, and Timo Ilari Kaakinen.
    • Research Group of Surgery, Anesthesiology and Intensive Care Medicine, Medical Research Center Oulu, Oulu University Hospital and University of Oulu, Oulu, Finland. Electronic address: ronkainenheikki@gmail.com.
    • J. Cardiothorac. Vasc. Anesth. 2024 Jul 1; 38 (7): 148414911484-1491.

    ObjectiveTo investigate the accuracy, precision, and trending ability of noninvasive bioreactance-based Starling SV and the mini invasive pulse-power device LiDCOrapid as compared to thermodilution cardiac output (TDCO) as measured by pulmonary artery catheter when assessing cardiac index (CIx) in the setting of elective open abdominal aortic (AA) surgery.DesignA prospective method-comparison study.SettingOulu University Hospital, Finland.ParticipantsForty patients undergoing elective open abdominal aortic surgery.InterventionsIntraoperative CI measurements were obtained simultaneously with TDCO and the study monitors, resulting in 627 measurement pairs with Starling SV and 497 with LiDCOrapid.Measurements And Main ResultsThe Bland-Altman method was used to investigate the agreement among the devices, and four-quadrant plots with error grids were used to assess trending ability. The agreement between TDCO and Starling SV was associated with a bias of 0.18 L/min/m2 (95% confidence interval [CI] = 0.13 to 0.23), wide limits of agreement (LOA = -1.12 to 1.47 L/min/m2), and a percentage error (PE) of 63.7 (95% CI = 52.4-71.0). The agreement between TDCO and LiDCOrapid was associated with a bias of -0.15 L/min/m2 (95% CI = -0.21 to -0.09), wide LOA (-1.56 to 1.37), and a PE of 68.7 (95% CI = 54.9-79.6). The trending ability of neither device was sufficient.ConclusionThe CI measurements achieved with Starling SV and LiDCOrapid were not interchangeable with TDCO, and the ability to track changes in CI was poor. These results do not support the use of either study device in monitoring CI during open AA surgery.Copyright © 2024 The Authors. Published by Elsevier Inc. All rights reserved.

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