• Rose-Marieke B G E Breukers, Shahrzad Sepehrkhouy, Stefan R Spiegelenberg, and A B Johan Groeneveld.
• Intensive Care Unit, Institute for Cardiovascular Research, VU University Medical Center, Amsterdam, the Netherlands.
• J. Cardiothorac. Vasc. Anesth. 2007 Oct 1;21(5):632-5.

ObjectivesTo investigate whether measuring cardiac output and its course after cardiac surgery by a new analysis technique of radial artery pressure waves, without need for calibration (FloTrac/Vigileo [FV]; Edwards Lifesciences, Irvine, CA), conforms to the standard bolus thermodilution method via a pulmonary artery catheter (PAC).DesignProspective study.SettingIntensive care unit of university hospital.ParticipantsTwenty patients for up to 24 hours after cardiac surgery.InterventionsSimultaneous and triplicate PAC thermodilution and FV cardiac output measurements at 1 and 3 hours after surgery and the following morning.Measurements And Main ResultsFifty-six simultaneous measurement sets were obtained. Mean cardiac output (PAC) ranged between 2.8 and 10.3 L/min and for the FV method between 3.3 and 8.8 L/min. The coefficient of variation for pooled measurements was 7.3% for the PAC and 3.0% for the FV method. For pooled data, the r2 was 0.55 (p < 0.001), with a bias of -0.14, precision of 1.00 L/min, and 95% limits of agreement between -2.14 and 1.87 L/min in a Bland-Altman plot. Also, the FV method tended to overestimate cardiac output when <7 L/min and increased with time, whereas mean arterial pressure increased and PAC cardiac output did not change. Changes in cardiac output correlated (r2 = 0.52, p < 0.001).ConclusionsThe FV arterial pressure waveform analysis method is a clinically applicable method for cardiac output assessment without calibration, after cardiac surgery. It performs well at low cardiac outputs but remains sensitive to changes in vascular tone.

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