[Semi-invasive monitoring of cardiac output in renal transplantation by a new device using arterial pressure waveform analysis compare with intermittent pulmonary thermodilution]

Takashi Terada, Yumi Maemura, Daisuke Toyoda, Ririko Iwasaki, Nobukazu Sato, Ryoichi Ochtai
Masui. the Japanese Journal of Anesthesiology 2010, 59 (7): 897-901

BACKGROUND: Clinical usefulness of PA catheter is controversial. We compared a new semi-invasive device (FloTrac/Vigileo) using arterial pressure waveform analysis for CO measurement in patients undergoing renal transplantation with bolus thermodilution method. Simultaneously CCO was measured, and we compared CCO with that obtained by bolus thermodilution method.

METHODS: Forty seven patients undergoing renal transplantation were enrolled. A PAC was inserted and radial arterial access was used for semi-invasive determination of CO (APCO) with the Vigileo. CO was measured simultaneously by bolus thermodilution and the Vigileo technique, and after starting operation, volume loading, before surgery, and other points were measured over 1 hour during measurements. And CCO was measured simultaneously at all points.

STATISTICAL ANALYSIS: Statistical analysis was performed using the method described by Bland and Altman. Bias was defined as the mean difference between the volumes obtained by pulmonary artery thermodilution and those by arterial pressure waveform analysis. Precision was expressed by the upper and lower limits of agreement.

RESULTS: Means of age, height and weight were 45 years, 163.8 cm and 59.2 kg, respectively. Regression analysis of CO; APCO and ICO showed y = 0.8x + 2.2, R2 = 0.57. CCO and ICO; y = 0.8x + 1.1, R2 = 0.74. Average of APCO and ICO; bias = -0.65. SD = 1.54 average of CCO and ICO; bias = 0.38, SD = 1.23.

CONCLUSIONS: In renal transplantation, CO measured by a new semi-invasive arterial pressure waveform analysis device showed good agreement with the volume obtained by intermittent pulmonary artery thermodilution method.

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