The cardiac output from blood pressure algorithms trial
Objective: The value of different algorithms that estimate cardiac output (CO) by analysis of a peripheral arterial blood pressure (ABP) waveform has not been definitively identified. In this investigation, we developed a testing data set containing a large number of radial ABP waveform segments and...
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| Format: | Article |
| Language: | en_US |
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Wolters Kluwer
2011
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| Online Access: | http://hdl.handle.net/1721.1/60982 https://orcid.org/0000-0002-6318-2978 https://orcid.org/0000-0002-2446-1499 |
| _version_ | 1811073301804482560 |
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| author | Sun, James X. Reisner, Andrew T. Saeed, Mohammed Heldt, Thomas Mark, Roger Greenwood |
| author2 | Harvard University--MIT Division of Health Sciences and Technology |
| author_facet | Harvard University--MIT Division of Health Sciences and Technology Sun, James X. Reisner, Andrew T. Saeed, Mohammed Heldt, Thomas Mark, Roger Greenwood |
| author_sort | Sun, James X. |
| collection | MIT |
| description | Objective: The value of different algorithms that estimate cardiac output (CO) by analysis of a peripheral arterial blood pressure (ABP) waveform has not been definitively identified. In this investigation, we developed a testing data set containing a large number of radial ABP waveform segments and contemporaneous reference CO by thermodilution measurements, collected in an intensive care unit (ICU) patient population during routine clinical operations. We employed this data set to evaluate a set of investigational algorithms, and to establish a public resource for the meaningful comparison of alternative CO-from-ABP algorithms.
Design: A retrospective comparative analysis of eight investigational CO-from-ABP algorithms using the Multiparameter Intelligent Monitoring in Intensive Care II database.
Setting: Mixed medical/surgical ICU of a university hospital.
Patients: A total of 120 cases.
Interventions: None.
Measurements: CO estimated by eight investigational CO-from-ABP algorithms, and COTD as a reference.
Main Results: All investigational methods were significantly better than mean arterial pressure (MAP) at estimating direction changes in COTD. Only the formula proposed by Liljestrand and Zander in 1928 was a significantly better quantitative estimator of COTD compared with MAP (95% limits-of-agreement with COTD: -1.76/+1.41 L/min versus -2.20/+1.82 L/min, respectively; p < 0.001, per the Kolmogorov-Smirnov test). The Liljestrand method was even more accurate when applied to the cleanest ABP waveforms. Other investigational algorithms were not significantly superior to MAP as quantitative estimators of CO.
Conclusions: Based on ABP data recorded during routine intensive care unit (ICU) operations, the Liljestrand and Zander method is a better estimator of COTD than MAP alone. Our attempts to fully replicate commercially-available methods were unsuccessful, and these methods could not be evaluated. However, the data set is publicly and freely available, and developers and vendors of CO-from-ABP algorithms are invited to test their methods using these data. |
| first_indexed | 2024-09-23T09:30:58Z |
| format | Article |
| id | mit-1721.1/60982 |
| institution | Massachusetts Institute of Technology |
| language | en_US |
| last_indexed | 2024-09-23T09:30:58Z |
| publishDate | 2011 |
| publisher | Wolters Kluwer |
| record_format | dspace |
| spelling | mit-1721.1/609822022-09-26T11:57:56Z The cardiac output from blood pressure algorithms trial Sun, James X. Reisner, Andrew T. Saeed, Mohammed Heldt, Thomas Mark, Roger Greenwood Harvard University--MIT Division of Health Sciences and Technology Massachusetts Institute of Technology. Research Laboratory of Electronics Mark, Roger Greenwood Sun, James X. Reisner, Andrew T. Saeed, Mohammed Heldt, Thomas Mark, Roger Greenwood Objective: The value of different algorithms that estimate cardiac output (CO) by analysis of a peripheral arterial blood pressure (ABP) waveform has not been definitively identified. In this investigation, we developed a testing data set containing a large number of radial ABP waveform segments and contemporaneous reference CO by thermodilution measurements, collected in an intensive care unit (ICU) patient population during routine clinical operations. We employed this data set to evaluate a set of investigational algorithms, and to establish a public resource for the meaningful comparison of alternative CO-from-ABP algorithms. Design: A retrospective comparative analysis of eight investigational CO-from-ABP algorithms using the Multiparameter Intelligent Monitoring in Intensive Care II database. Setting: Mixed medical/surgical ICU of a university hospital. Patients: A total of 120 cases. Interventions: None. Measurements: CO estimated by eight investigational CO-from-ABP algorithms, and COTD as a reference. Main Results: All investigational methods were significantly better than mean arterial pressure (MAP) at estimating direction changes in COTD. Only the formula proposed by Liljestrand and Zander in 1928 was a significantly better quantitative estimator of COTD compared with MAP (95% limits-of-agreement with COTD: -1.76/+1.41 L/min versus -2.20/+1.82 L/min, respectively; p < 0.001, per the Kolmogorov-Smirnov test). The Liljestrand method was even more accurate when applied to the cleanest ABP waveforms. Other investigational algorithms were not significantly superior to MAP as quantitative estimators of CO. Conclusions: Based on ABP data recorded during routine intensive care unit (ICU) operations, the Liljestrand and Zander method is a better estimator of COTD than MAP alone. Our attempts to fully replicate commercially-available methods were unsuccessful, and these methods could not be evaluated. However, the data set is publicly and freely available, and developers and vendors of CO-from-ABP algorithms are invited to test their methods using these data. National Institute of Biomedical Imaging and Bioengineering (U.S.) (R01-EB001659) Center for Integration of Medicine and Innovative Technology 2011-02-18T16:33:19Z 2011-02-18T16:33:19Z 2009-01 2007-07 Article http://purl.org/eprint/type/JournalArticle 0090-3493 http://hdl.handle.net/1721.1/60982 Sun, James X. et al. "The cardiac output from blood pressure algorithms trial." Critical Care Medicine. 37(1):72-80, January 2009. https://orcid.org/0000-0002-6318-2978 https://orcid.org/0000-0002-2446-1499 en_US http://dx.doi.org/10.1097/CCM.0b013e3181930174 Critical Care Medicine Attribution-Noncommercial-Share Alike 3.0 http://creativecommons.org/licenses/by-nc-sa/3.0/ application/pdf Wolters Kluwer Prof. Mark via Courtney Crummett |
| spellingShingle | Sun, James X. Reisner, Andrew T. Saeed, Mohammed Heldt, Thomas Mark, Roger Greenwood The cardiac output from blood pressure algorithms trial |
| title | The cardiac output from blood pressure algorithms trial |
| title_full | The cardiac output from blood pressure algorithms trial |
| title_fullStr | The cardiac output from blood pressure algorithms trial |
| title_full_unstemmed | The cardiac output from blood pressure algorithms trial |
| title_short | The cardiac output from blood pressure algorithms trial |
| title_sort | cardiac output from blood pressure algorithms trial |
| url | http://hdl.handle.net/1721.1/60982 https://orcid.org/0000-0002-6318-2978 https://orcid.org/0000-0002-2446-1499 |
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