• Kohshi Hattori, Takuma Maeda, Tetsuhito Masubuchi, Atsushi Yoshikawa, Keigo Ebuchi, Kuniko Morishima, Masataka Kamei, Kenji Yoshitani, and Yoshihiko Ohnishi.
• Department of Anesthesiology, National Cerebral and Cardiovascular Center, Osaka, Japan.
• J. Cardiothorac. Vasc. Anesth. 2017 Feb 1; 31 (1): 99-104.

ObjectivesTo determine the accuracy and trending ability of the fourth-generation FloTrac/Vigileo in patients with low cardiac index by comparing FloTrac/Vigileo-derived cardiac index with that measured by 3-dimensional echocardiography.DesignProspective clinical study.SettingCardiac surgery operating room in a single cardiovascular center.ParticipantsTwenty-five patients undergoing elective cardiac resynchronization therapy lead implantation.InterventionsFloTrac/Vigileo-derived cardiac index and 3-dimensional echocardiography-derived cardiac index were determined simultaneously before and after phenylephrine bolus and cardiac resynchronization therapy using 3-dimensional echocardiography-derived cardiac index as the reference method.Measurements And Main ResultsCardiac index measured by the fourth-generation FloTrac/Vigileo had a wide limit of agreement with that measured by 3-dimensional echocardiography, with a percentage error of 59.1%. The tracking ability of the unit after both phenylephrine administration and cardiac resynchronization therapy were measured by concordance rate, and both were below the acceptable limit (72.7% and 85%, respectively).ConclusionsThe degree of accuracy of the fourth-generation FloTrac/Vigileo in patients with low cardiac index was not acceptable, and high systemic vascular resistance in patients with low cardiac index may have contributed to this inaccuracy. The tracking ability of the fourth-generation FloTrac/Vigileo after phenylephrine administration or cardiac resynchronization therapy was below acceptable limits.Copyright © 2017 Elsevier Inc. All rights reserved.

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