Intraoperative cardiac function assessment by transesophageal echocardiography versus FloTrac/Vigileo™ system during pectus excavatum surgical repair
Abstract Background Pectus excavatum (PE), a congenital deformity of the chest wall, can lead to cardiac compression and related symptoms. PE surgical repair can improve cardiac function. Intraoperative transesophageal echocardiography (TEE) has been successfully employed to assess intraoperative he...
| Main Authors: | , , , , , , , , , , , |
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| Format: | Article |
| Language: | English |
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BMC
2021-12-01
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| Series: | Journal of Anesthesia, Analgesia and Critical Care |
| Subjects: | |
| Online Access: | https://doi.org/10.1186/s44158-021-00025-4 |
| _version_ | 1811250037296988160 |
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| author | Silvia Fiorelli Gelsomina Capua Cecilia Menna Claudio Andreetti Elisabetta Giorni Ettore Riva Elisabetta Agostini Fabrizio D’Andrea Elisa Massullo Valentina Peritore Monica Rocco Domenico Massullo |
| author_facet | Silvia Fiorelli Gelsomina Capua Cecilia Menna Claudio Andreetti Elisabetta Giorni Ettore Riva Elisabetta Agostini Fabrizio D’Andrea Elisa Massullo Valentina Peritore Monica Rocco Domenico Massullo |
| author_sort | Silvia Fiorelli |
| collection | DOAJ |
| description | Abstract Background Pectus excavatum (PE), a congenital deformity of the chest wall, can lead to cardiac compression and related symptoms. PE surgical repair can improve cardiac function. Intraoperative transesophageal echocardiography (TEE) has been successfully employed to assess intraoperative hemodynamic variations in patients undergoing PE repair. FloTrac/Vigileo™ system (Edwards Life-sciences Irvine, CA) (FT/V) is a minimally invasive cardiac output monitoring system. This retrospective study aimed to assess hemodynamic changes in surgical repair of PE using FT/V and concordance with parameters measured by TEE. Results N=19 patients submitted to PE repair via Ravitch or Nuss technique were enrolled. Intraoperative cardiac assessments simultaneously obtained via TEE and FT/V system were investigated. The agreement between TEE-derived cardiac output (CO-TEE) and FT/V system parameter (COAP) was evaluated. The relationship between COTEE and COAP was analyzed for all data using linear regression analysis. A significant correlation between COAP and COTEE values (R = 0.65, p < 0.001) was found. Bland-Altman analysis of COAP and COTEE showed a bias of 0.13 L/min and a limit of agreement of − 2.33 to 2.58 L/min, with a percentage error of 48%. Intraoperative measurements by TEE and FT/V both showed a significant increase in CO after surgical correction of PE (p < 0.005). Conclusions FT/V system compared to TEE in hemodynamic monitoring during PE surgery yielded clinically unacceptable results due to a high percentage error. After surgical correction of PE, CO, measured by TEE and FT/V, significantly improved. |
| first_indexed | 2024-04-12T15:58:10Z |
| format | Article |
| id | doaj.art-53db08659908468987cbce4db42aa0e7 |
| institution | Directory Open Access Journal |
| issn | 2731-3786 |
| language | English |
| last_indexed | 2024-04-12T15:58:10Z |
| publishDate | 2021-12-01 |
| publisher | BMC |
| record_format | Article |
| series | Journal of Anesthesia, Analgesia and Critical Care |
| spelling | doaj.art-53db08659908468987cbce4db42aa0e72022-12-22T03:26:17ZengBMCJournal of Anesthesia, Analgesia and Critical Care2731-37862021-12-01111710.1186/s44158-021-00025-4Intraoperative cardiac function assessment by transesophageal echocardiography versus FloTrac/Vigileo™ system during pectus excavatum surgical repairSilvia Fiorelli0Gelsomina Capua1Cecilia Menna2Claudio Andreetti3Elisabetta Giorni4Ettore Riva5Elisabetta Agostini6Fabrizio D’Andrea7Elisa Massullo8Valentina Peritore9Monica Rocco10Domenico Massullo11Anesthesia and Intensive Care Medicine, Department of Clinical and Surgical Translational Medicine, Sapienza University of RomeAnesthesia and Intensive Care Medicine, Department of Clinical and Surgical Translational Medicine, Sapienza University of RomeThoracic Surgery, Department of Clinical and Surgical Translational Medicine, Sapienza University of RomeThoracic Surgery, Department of Clinical and Surgical Translational Medicine, Sapienza University of RomeAnesthesia and Intensive Care Medicine, Department of Clinical and Surgical Translational Medicine, Sapienza University of RomeAnesthesia and Intensive Care Medicine, Department of Clinical and Surgical Translational Medicine, Sapienza University of RomeAnesthesia and Intensive Care Medicine, Department of Clinical and Surgical Translational Medicine, Sapienza University of RomeDivision of Cardiology, Department of Clinical and Molecular Medicine, University of RomeThoracic Surgery, Department of Clinical and Surgical Translational Medicine, Sapienza University of RomeThoracic Surgery, Department of Clinical and Surgical Translational Medicine, Sapienza University of RomeAnesthesia and Intensive Care Medicine, Department of Clinical and Surgical Translational Medicine, Sapienza University of RomeAnesthesia and Intensive Care Medicine, Department of Clinical and Surgical Translational Medicine, Sapienza University of RomeAbstract Background Pectus excavatum (PE), a congenital deformity of the chest wall, can lead to cardiac compression and related symptoms. PE surgical repair can improve cardiac function. Intraoperative transesophageal echocardiography (TEE) has been successfully employed to assess intraoperative hemodynamic variations in patients undergoing PE repair. FloTrac/Vigileo™ system (Edwards Life-sciences Irvine, CA) (FT/V) is a minimally invasive cardiac output monitoring system. This retrospective study aimed to assess hemodynamic changes in surgical repair of PE using FT/V and concordance with parameters measured by TEE. Results N=19 patients submitted to PE repair via Ravitch or Nuss technique were enrolled. Intraoperative cardiac assessments simultaneously obtained via TEE and FT/V system were investigated. The agreement between TEE-derived cardiac output (CO-TEE) and FT/V system parameter (COAP) was evaluated. The relationship between COTEE and COAP was analyzed for all data using linear regression analysis. A significant correlation between COAP and COTEE values (R = 0.65, p < 0.001) was found. Bland-Altman analysis of COAP and COTEE showed a bias of 0.13 L/min and a limit of agreement of − 2.33 to 2.58 L/min, with a percentage error of 48%. Intraoperative measurements by TEE and FT/V both showed a significant increase in CO after surgical correction of PE (p < 0.005). Conclusions FT/V system compared to TEE in hemodynamic monitoring during PE surgery yielded clinically unacceptable results due to a high percentage error. After surgical correction of PE, CO, measured by TEE and FT/V, significantly improved.https://doi.org/10.1186/s44158-021-00025-4Pectus excavatumCardiac outputTransesophageal echocardiographyPulse contour analysesFloTrac/Vigileo |
| spellingShingle | Silvia Fiorelli Gelsomina Capua Cecilia Menna Claudio Andreetti Elisabetta Giorni Ettore Riva Elisabetta Agostini Fabrizio D’Andrea Elisa Massullo Valentina Peritore Monica Rocco Domenico Massullo Intraoperative cardiac function assessment by transesophageal echocardiography versus FloTrac/Vigileo™ system during pectus excavatum surgical repair Journal of Anesthesia, Analgesia and Critical Care Pectus excavatum Cardiac output Transesophageal echocardiography Pulse contour analyses FloTrac/Vigileo |
| title | Intraoperative cardiac function assessment by transesophageal echocardiography versus FloTrac/Vigileo™ system during pectus excavatum surgical repair |
| title_full | Intraoperative cardiac function assessment by transesophageal echocardiography versus FloTrac/Vigileo™ system during pectus excavatum surgical repair |
| title_fullStr | Intraoperative cardiac function assessment by transesophageal echocardiography versus FloTrac/Vigileo™ system during pectus excavatum surgical repair |
| title_full_unstemmed | Intraoperative cardiac function assessment by transesophageal echocardiography versus FloTrac/Vigileo™ system during pectus excavatum surgical repair |
| title_short | Intraoperative cardiac function assessment by transesophageal echocardiography versus FloTrac/Vigileo™ system during pectus excavatum surgical repair |
| title_sort | intraoperative cardiac function assessment by transesophageal echocardiography versus flotrac vigileo™ system during pectus excavatum surgical repair |
| topic | Pectus excavatum Cardiac output Transesophageal echocardiography Pulse contour analyses FloTrac/Vigileo |
| url | https://doi.org/10.1186/s44158-021-00025-4 |
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