• H Paarmann, H V Groesdonk, B Sedemund-Adib, T Hanke, H Heinze, M Heringlake, and J Schön.
• Department of Anesthesiology, University of Lübeck, Ratzeburger Allee 160, D-23538 Lübeck, Germany.
• Br J Anaesth. 2011 Apr 1;106(4):475-81.

BackgroundPulse-contour analysis method (PCM) cardiac output (CO) monitors are increasingly used for CO monitoring during anaesthesia and in the critically ill. Very recently, several systems have been introduced that do not need calibration; among them the pressure recording analytical method (PRAM). Sparse data comparing the accuracy of the PRAM-CO with conventional thermodilution CO (ThD-CO) in cardiac surgery patients are available.MethodsIn this prospective comparison study, paired CO measurements with a pulmonary artery catheter and a PRAM monitoring set were obtained 20-30 min apart (t1, t2) in 23 extubated patients on the first postoperative day after cardiac surgery. Data were analysed by the Bland-Altman method.ResultsA total of 46 paired CO measurements (23 for each interval) were collected. The Bland-Altman analysis showed a mean difference (bias) of 0.0 litre min(-1) and limits of agreement (1.96 sd) of 4.53 to -4.54 litre min(-1) [upper 95% confidence interval (CI), 3.26-5.80; lower 95% CI, -5.8 to -3.27]. The percentage error (1.96 sd/mean of the reference method) was 87%.ConclusionsThese results question the reliability of the PRAM technology for the determination of CO in postoperative cardiac surgery patients.

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