Reliability of non-invasive cardiac output monitoring based on pulse wave transit time in off-pump coronary artery bypass grafting
<p><strong>Aim:</strong> The study was designed to evaluate the accuracy of cardiac output (CO) measurements based on pulse wave transit time (PWTT) as compared to transpulmonary thermodilution (TPTD) in perioperative off-pump coronary artery bypass grafting (OPCABG).<br />&l...
| Main Authors: | , , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
Meshalkin National Medical Research Center
2016-08-01
|
| Series: | Патология кровообращения и кардиохирургия |
| Subjects: | |
| Online Access: | http://journalmeshalkin.ru/index.php/heartjournal/article/view/321 |
| _version_ | 1827851944338653184 |
|---|---|
| author | А. А. Смёткин А. Хусcейн В. И. Захаров Н. Н. Изотова В. В. Кузьков М. Ю. Киров |
| author_facet | А. А. Смёткин А. Хусcейн В. И. Захаров Н. Н. Изотова В. В. Кузьков М. Ю. Киров |
| author_sort | А. А. Смёткин |
| collection | DOAJ |
| description | <p><strong>Aim:</strong> The study was designed to evaluate the accuracy of cardiac output (CO) measurements based on pulse wave transit time (PWTT) as compared to transpulmonary thermodilution (TPTD) in perioperative off-pump coronary artery bypass grafting (OPCABG).<br /><strong>Methods:</strong> 20 patients scheduled for elective OPCABG were enrolled for a prospective study. Parallel measurements of CO by using PWTT (COPWTT) and TPTD (COTPTD) were carried out at five stages intraoperatively and at three stages postoperatively. Also analyzed was the agreement between CO absolute values and its ability to monitor cardiac output dynamics. <br /><strong>Results:</strong> All in all, 153 pairs of CO data were obtained. According to Bland–Altman analysis, the mean intraoperative difference between the methods was 1.2 L/min, with boundaries of agreement reaching ± 2.9 L/min and a percentage error amounting to 64%. The intraoperative analysis of a polar plot revealed an increased angular difference of 6.9º and radial boundaries of agreement of ± 70.4º, and a decreased polar concordance rate (55%). The postoperative analysis of the data showed better agreement between the methods: mean difference was 0.4 L/min with boundaries of agreement of ± 2.3 L/min and percentage error of 41%. The postoperative trending ability was also more accurate (angular difference of 3.2º, angular boundaries of agreement ± 39º, polar concordance rate 81%).<br /><strong>Conclusion:</strong> Poor accuracy and reproducibility of non-invasive COPWTT and its insufficient trending ability to monitor cardiac output during off-pump coronary artery bypass grafting makes it impossible to recommend this technology to be used intraoperatively as an alternative to transpulmonary thermodilution technique. The calibration and trending ability of COPWTT improved after OPCAB.</p> |
| first_indexed | 2024-03-12T10:41:06Z |
| format | Article |
| id | doaj.art-cff8423b87504fc9bf97dd9cb6abe6ad |
| institution | Directory Open Access Journal |
| issn | 1681-3472 2500-3119 |
| language | English |
| last_indexed | 2024-03-12T10:41:06Z |
| publishDate | 2016-08-01 |
| publisher | Meshalkin National Medical Research Center |
| record_format | Article |
| series | Патология кровообращения и кардиохирургия |
| spelling | doaj.art-cff8423b87504fc9bf97dd9cb6abe6ad2023-09-02T08:10:18ZengMeshalkin National Medical Research CenterПатология кровообращения и кардиохирургия1681-34722500-31192016-08-0120210411010.21688/1681-3472-2016-2-104-1101022Reliability of non-invasive cardiac output monitoring based on pulse wave transit time in off-pump coronary artery bypass graftingА. А. Смёткин0А. Хусcейн1В. И. Захаров2Н. Н. Изотова3В. В. Кузьков4М. Ю. Киров5Северный государственный медицинский университет Министерства здравоохранения Российской Федерации, 163000, Архангельск, пр. Троицкий, 51; Первая городская клиническая больница имени Е.Е. Волосевич, 163001, Архангельск, ул. Суворова, 1Северный государственный медицинский университет Министерства здравоохранения Российской Федерации, 163000, Архангельск, пр. Троицкий, 51Северный государственный медицинский университет Министерства здравоохранения Российской Федерации, 163000, Архангельск, пр. Троицкий, 51Северный государственный медицинский университет Министерства здравоохранения Российской Федерации, 163000, Архангельск, пр. Троицкий, 51Северный государственный медицинский университет Министерства здравоохранения Российской Федерации, 163000, Архангельск, пр. Троицкий, 51; Первая городская клиническая больница имени Е.Е. Волосевич, 163001, Архангельск, ул. Суворова, 1Северный государственный медицинский университет Министерства здравоохранения Российской Федерации, 163000, Архангельск, пр. Троицкий, 51; Первая городская клиническая больница имени Е.Е. Волосевич, 163001, Архангельск, ул. Суворова, 1<p><strong>Aim:</strong> The study was designed to evaluate the accuracy of cardiac output (CO) measurements based on pulse wave transit time (PWTT) as compared to transpulmonary thermodilution (TPTD) in perioperative off-pump coronary artery bypass grafting (OPCABG).<br /><strong>Methods:</strong> 20 patients scheduled for elective OPCABG were enrolled for a prospective study. Parallel measurements of CO by using PWTT (COPWTT) and TPTD (COTPTD) were carried out at five stages intraoperatively and at three stages postoperatively. Also analyzed was the agreement between CO absolute values and its ability to monitor cardiac output dynamics. <br /><strong>Results:</strong> All in all, 153 pairs of CO data were obtained. According to Bland–Altman analysis, the mean intraoperative difference between the methods was 1.2 L/min, with boundaries of agreement reaching ± 2.9 L/min and a percentage error amounting to 64%. The intraoperative analysis of a polar plot revealed an increased angular difference of 6.9º and radial boundaries of agreement of ± 70.4º, and a decreased polar concordance rate (55%). The postoperative analysis of the data showed better agreement between the methods: mean difference was 0.4 L/min with boundaries of agreement of ± 2.3 L/min and percentage error of 41%. The postoperative trending ability was also more accurate (angular difference of 3.2º, angular boundaries of agreement ± 39º, polar concordance rate 81%).<br /><strong>Conclusion:</strong> Poor accuracy and reproducibility of non-invasive COPWTT and its insufficient trending ability to monitor cardiac output during off-pump coronary artery bypass grafting makes it impossible to recommend this technology to be used intraoperatively as an alternative to transpulmonary thermodilution technique. The calibration and trending ability of COPWTT improved after OPCAB.</p>http://journalmeshalkin.ru/index.php/heartjournal/article/view/321сердечный выбросгемодинамикавремя транзита пульсовой волнытранспульмональная термодилюция |
| spellingShingle | А. А. Смёткин А. Хусcейн В. И. Захаров Н. Н. Изотова В. В. Кузьков М. Ю. Киров Reliability of non-invasive cardiac output monitoring based on pulse wave transit time in off-pump coronary artery bypass grafting Патология кровообращения и кардиохирургия сердечный выброс гемодинамика время транзита пульсовой волны транспульмональная термодилюция |
| title | Reliability of non-invasive cardiac output monitoring based on pulse wave transit time in off-pump coronary artery bypass grafting |
| title_full | Reliability of non-invasive cardiac output monitoring based on pulse wave transit time in off-pump coronary artery bypass grafting |
| title_fullStr | Reliability of non-invasive cardiac output monitoring based on pulse wave transit time in off-pump coronary artery bypass grafting |
| title_full_unstemmed | Reliability of non-invasive cardiac output monitoring based on pulse wave transit time in off-pump coronary artery bypass grafting |
| title_short | Reliability of non-invasive cardiac output monitoring based on pulse wave transit time in off-pump coronary artery bypass grafting |
| title_sort | reliability of non invasive cardiac output monitoring based on pulse wave transit time in off pump coronary artery bypass grafting |
| topic | сердечный выброс гемодинамика время транзита пульсовой волны транспульмональная термодилюция |
| url | http://journalmeshalkin.ru/index.php/heartjournal/article/view/321 |
| work_keys_str_mv | AT aasmëtkin reliabilityofnoninvasivecardiacoutputmonitoringbasedonpulsewavetransittimeinoffpumpcoronaryarterybypassgrafting AT ahuscejn reliabilityofnoninvasivecardiacoutputmonitoringbasedonpulsewavetransittimeinoffpumpcoronaryarterybypassgrafting AT vizaharov reliabilityofnoninvasivecardiacoutputmonitoringbasedonpulsewavetransittimeinoffpumpcoronaryarterybypassgrafting AT nnizotova reliabilityofnoninvasivecardiacoutputmonitoringbasedonpulsewavetransittimeinoffpumpcoronaryarterybypassgrafting AT vvkuzʹkov reliabilityofnoninvasivecardiacoutputmonitoringbasedonpulsewavetransittimeinoffpumpcoronaryarterybypassgrafting AT mûkirov reliabilityofnoninvasivecardiacoutputmonitoringbasedonpulsewavetransittimeinoffpumpcoronaryarterybypassgrafting |