Assessment of Trending Ability of Cardiac Output Monitors by Polar Plot Methodology

2011 ◽  
Vol 25 (3) ◽  
pp. 536-546 ◽  
Author(s):  
Lester A. Critchley ◽  
Xiao X. Yang ◽  
Anna Lee
Keyword(s):  
Cardiac Output ◽  
Polar Plot ◽  
Trending Ability

scholarly journals Cardiac Output Evaluation on Septic Shock Patients: Comparison between Calibrated and Uncalibrated Devices during Vasopressor Therapy

2021 ◽  
Vol 10 (2) ◽  
pp. 213
Author(s):  
Paolo Persona ◽  
Ilaria Valeri ◽  
Elisabetta Saraceni ◽  
Alessandro De Cassai ◽  
Fabrizia Calabrese ◽  
...  
Keyword(s):  
Septic Shock ◽  
Cardiac Output ◽  
Volume Expansion ◽  
Transpulmonary Thermodilution ◽  
Percentage Error ◽  
Arterial Waveform ◽  
Polar Plot ◽  
Norepinephrine Infusion ◽  
The Mean ◽  
Trending Ability

There are no reliable, non-invasive methods to accurately measure cardiac output (CO) in septic patients. MostCare (Vytech Health™, Vygon, Padova, Italy), is a beat-to-beat, self calibrated method for CO measurement based on continuous analysis of reflected arterial pressure waveforms. We enrolled 40 patients that were suffering from septic shock and requiring norepinephrine infusion to target blood pressure in order to to evaluate the level of agreement between a calibrated transpulmonary thermodilution device (PiCCO System, Pulsion Medical Systems, Feldkirchen, Germany) and the MostCare system in detecting and tracking changes in CO measurements related to norepinephrine reduction in septic shock patients,. PiCCO was connected to a 5 Fr femoral artery catheter and to a central venous catheter. System calibration was performed with 15 mL of cold saline injection over about 3 s. The MostCare device was connected to the artery catheter to analyze the arterial waveform. Before reducing norepinephrine infusion, the PiCCO system was calibrated, the MostCare waveform was optimized, and the values of the complete hemodynamic profile were recorded (T1). Norepinephrine infusion was then reduced by 0.03 mcg/Kg/min. After 30 min, a new calibration of PiCCO system and a new record on both monitors were performed (T2). Static measurements agreements were assessed using the Bland-Altman test, while trending ability was investigated using polar plot analysis. If volume expansion occurred, then related data were separately analyzed. At T1 mean the CO was 5.38 (SD 0.60) L/min, the mean difference was 0.176 L/min, the limits of agreement (LoA) was +1.39 and −1.04 L/min, and the percentage error (PE) was 22.6%; at T2 the mean CO was 5.44 (SD 0.73) L/min, the mean difference was 0.053 L/min, the LoA was +1.51 and −1.40, and the PE was 27%. After considering the volume expansion between T1 and T2, the mean CO at T1 was 5.39 L/min (SD 0.47), the LoA was +1.09 and −0.78 L/min, and the percentage error (PE) was 17%; at T2 the mean CO was 5.35 L/min (SD 0.81), the LoA was +1.73 and −1.52 L/min, and the PE was 30%. The polar plot diagram seems to confirm the trending ability of MostCare system versus the reference method. In septic patients, when the arterial waveform is accurate, MostCare and PiCCO transpulmonary thermodilution exhibit good agreement even after the reduction of norepinephrine and changes in vascular tone or volume expansion. MostCare could be a rapid to set, reliable, and useful tool to monitor hemodynamic variations in septic patients in emergency contexts where thermodilution methods or other advanced systems are not easily available.

Assessing accuracy of a non-invasive monitor for cardiac output, compared to the LiDCOrapid: the polar plot method

2013 ◽  
Vol 30 ◽  
pp. 48-48
Author(s):  
Lombana V. Anillo ◽  
R. Schiraldi ◽  
Martinez M.M. Lopez ◽  
G. Maggi ◽  
N. Brogly ◽  
...  
Keyword(s):  
Cardiac Output ◽  
Polar Plot ◽  
Non Invasive

Lack of agreement and trending ability of the endotracheal cardiac output monitor compared with thermodilution

2011 ◽  
Vol 56 (4) ◽  
pp. 433-440 ◽  
Author(s):  
H. MØLLER-SØRENSEN ◽  
K. L. HANSEN ◽  
M. ØSTERGAARD ◽  
L. W. ANDERSEN ◽  
K. MØLLER
Keyword(s):  
Cardiac Output ◽  
Cardiac Output Monitor ◽  
Trending Ability

scholarly journals Nexfin Noninvasive Continuous Hemodynamic Monitoring: Validation against Continuous Pulse Contour and Intermittent Transpulmonary Thermodilution Derived Cardiac Output in Critically Ill Patients

2013 ◽  
Vol 2013 ◽  
pp. 1-11 ◽  
Author(s):  
Koen Ameloot ◽  
Katrijn Van De Vijver ◽  
Ole Broch ◽  
Niels Van Regenmortel ◽  
Inneke De laet ◽  
...  
Keyword(s):  
Cardiac Output ◽  
Critically Ill ◽  
Critically Ill Patients ◽  
Pulse Contour Analysis ◽  
Pulse Contour ◽  
Time Interval ◽  
Medical Systems ◽  
Contour Analysis ◽  
Limits Of Agreement ◽  
Polar Plot

Introduction. Nexfin (Bmeye, Amsterdam, Netherlands) is a noninvasive cardiac output (CO) monitor based on finger arterial pulse contour analysis. The aim of this study was to validate Nexfin CO (NexCO) against thermodilution (TDCO) and pulse contour CO (CCO) by PiCCO (Pulsion Medical Systems, Munich, Germany).Patients and Methods. In a mix of critically ill patients (n=45), NexCO and CCO were measured continuously and recorded at 2-hour intervals during the 8-hour study period. TDCO was measured at 0–4–8 hrs.Results. NexCO showed a moderate to good (significant) correlation with TDCO (R20.68,P<0.001) and CCO (R20.71,P<0.001). Bland and Altman analysis comparing NexCO with TDCO revealed a bias (± limits of agreement, LA) of 0.4 ± 2.32 L/min (with 36% error) while analysis comparing NexCO with CCO showed a bias (±LA) of 0.2 ± 2.32 L/min (37% error). NexCO is able to follow changes in TDCO and CCO during the same time interval (level of concordance 89.3% and 81%). Finally, polar plot analysis showed that trending capabilities were acceptable when changes in NexCO (ΔNexCO) were compared toΔTDCO andΔCCO (resp., 89% and 88.9% of changes were within the level of 10% limits of agreement).Conclusion. we found a moderate to good correlation between CO measurements obtained with Nexfin and PiCCO.

scholarly journals Accuracy and trending abilities of finger plethysmographic blood pressure and cardiac output compared with invasive measurements during caesarean delivery in healthy women. An observational study.

2020 ◽  
Author(s):  
Ivar Nagelgaard Omenås ◽  
Christian Tronstad ◽  
Leiv Arne Rosseland
Keyword(s):  
Blood Pressure ◽  
Cardiac Output ◽  
Caesarean Section ◽  
Spinal Anaesthesia ◽  
Caesarean Delivery ◽  
Limits Of Agreement ◽  
Polar Plot ◽  
Non Invasive ◽  
Healthy Women ◽  
Cardiac Output Measurements

Abstract Background: In women presenting for caesarean section under spinal anaesthesia, continuous measurement of circulatory aspects, such as blood pressure and cardiac output, is often needed. At present, invasive techniques are used almost exclusively. Reliable non-invasive monitors would be welcome, as they could be safer and less uncomfortable, while easy and quick to apply. We aimed to evaluate whether a non-invasive, finger plethysmographic device, the ccNexFin monitor, can replace invasively measured blood pressure in the radial artery, and whether cardiac output measurements from this device can be used interchangeably with measurements from the mini-invasive LiDCO monitor, currently in use at our institution. Methods: Simultaneous invasive measurements were compared with ccNexFin in 23 healthy women during elective caesarean section under spinal anaesthesia. We used Bland Altman statistics for assessing agreement, and polar plot methodology for judging trending abilities with pre-defined limits. Results: Mean arterial and systolic pressures showed biases (invasive – ccNexFin) of -4.3 and 12.2 mmHg, with limits of agreement of -15.9 – 7.4 and -11.1 – 35.6, respectively. The ccNexFin trending abilities were within suggested limits for mean pressure, but insufficient for systolic pressure compared with invasive measurements. Cardiac output had a small bias of 0.2 L/min, but wide limits of agreement of -2.6 – 3.0. The ccNexFin trending abilities compared with the invasive estimated values (LiDCO) were unsatisfactory. Conclusions: We consider the ccNexFin monitor to have sufficient accuracy in measuring mean arterial pressures. The limits of agreement for systolic measurements were wider, and the trending ability, compared with invasive measurements, was outside the recommended limit. The ccNexFin is not reliable for cardiac output measurements or trend in pregnant women for caesarean delivery under spinal anaesthesia.

scholarly journals The Accuracy and Reliability of Cardiac Output Assessment by Measuring Descending Aortic Blood Flow in Patients Undergoing Cardiac Surgery

2021 ◽  
Author(s):  
Ling Peng ◽  
Jun Zeng ◽  
Wei Wei
Keyword(s):  
Blood Flow ◽  
Cardiac Output ◽  
Cardiac Surgery ◽  
Resistance Index ◽  
Aortic Blood Flow ◽  
Polar Plot ◽  
Aortic Blood ◽  
Average Proportion ◽  
Cardiac Output Index ◽  
One Way Anova

Abstract Background To investigate the accuracy and reliability of cardiac output (CO) assessment by transesophageal echocardiographic (TEE) measuring descending aortic blood flow (DABF) in patients undergoing cardiac surgery under cardiopulmonary bypass (CPB). And the influence of DABF/CO on the accuracy and reliability of CO assessment were also analyzed. Methods Paired CO measured by both thermodilution (TCO) and Doppler method (DCO) were obtained before incision, immediately after CPB, 15 minutes after CPB, 30 minutes after CPB, 45 minutes after CPB, and at the end of surgery. The DCO was converted from TEE measured DABF using theoretical proportion (70%) of DABF/CO. Regression analysis, Bland-Altman graph, and Polar plot were used to analyze the correlation and agreement between the CO measurements by the two methods. Parameters were compared by one-way ANOVA among different time points. Results A total of 132 pairs of CO measurements were obtained from 22 patients. The average proportion of DABF/TCO ranged from 54% before CPB to 63% after CBP. A good correlation between DCO and TCO (r = 0.81) was found. The Bland-Altman analysis showed a large positive bias between the TCO and DCO. The Polar plot also showed a poor concordance between changes of DCO and TCO. The proportion of DABF/TCO had a mild negative correlation with systemic vascular resistance index (SVRI) but not with cardiac output index (CI). Conclusions The CO, converted from TEE measured DABF, was underestimated in patients undergoing cardiac surgery. The varied proportion between DABF and CO mainly influenced the accuracy and reliability of CO assessment. Trial registration: Chinese Clinical Trials Register Identifier: ChiCTR-OCS-12002789 (retrospective registered). Date: 2012.12.21

Ability of the Third-Generation FloTrac/Vigileo Software to Track Changes in Cardiac Output in Cardiac Surgery Patients: A Polar Plot Approach

2013 ◽  
Vol 27 (6) ◽  
pp. 1122-1127 ◽  
Author(s):  
Olivier Desebbe ◽  
Roland Henaine ◽  
Geoffray Keller ◽  
Catherine Koffel ◽  
Hans Garcia ◽  
...  
Keyword(s):  
Cardiac Output ◽  
Cardiac Surgery ◽  
Third Generation ◽  
Polar Plot ◽  
The Third
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