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Faculty of Medical Sciences

Vergelijking van een non-invasieve met twee minimaal invasieve cardiac output monitoren tijdens off-pump coronaire bypassoperatie

Visser, E.M (2014) Vergelijking van een non-invasieve met twee minimaal invasieve cardiac output monitoren tijdens off-pump coronaire bypassoperatie. thesis, Medicine.

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Abstract

Background Cardiac index (CI) can be measured using arterial pressure curve analysis, which can be derived either minimally invasive from the radial artery (e.g. FloTrac-Vigileo (CIFTV) or ProAQT-Pulsioflex (CIPA)) or completely non-invasively with a finger cuff (e.g. ccNexfin (CINF)). Assuming that CIFTV and CIPA are clinically interchangeable, we compared CIFTV and CIPA with each other and the average of the minimal invasive CIFTV and CIPA (CIAVR) with non-invasive CINF. Methods In 70 patients undergoing off-pump coronary artery bypass surgery, CI was compared at predefined events during anesthesia (before and after induction of anesthesia, before and after sternotomy). Values were compared by Bland-Altman analysis for repeated measures. Four-quadrant plots and polar plot methodology were used to evaluate CI trending ability. Results Agreement analysis of CIFTV versus CIPA showed a bias of -0.2 L·min-1·m-2, limits of agreement (LOA) of ±1.4 L·min-1·m-2 and percentage error (PE) 103%. CINF slightly underestimated CI compared to CIAVR with a bias of 0.6 L·min-1·m-2, LOA of ±1.6 L·min-1·m-2, PE 102%. Polar plot analysis revealed moderate concordance to track CI changes comparing CIFTV to CIPA and CIAVR to CINF (83% and 90% within 30° limits of agreement). Conclusions The arterial pressure curve derived CIFTV and CIPA reveal a similar agreement and trending ability with each other as with noninvasive CINF. Therefore, noninvasive CINF can be considered as interchangeable with the minimal invasive CO monitors.

Item Type: Thesis (Thesis)
Supervisor name: Berg, dr. J.P. van den and Kalmar, dr. A.F.
Faculty: Medical Sciences
Date Deposited: 25 Jun 2020 11:06
Last Modified: 25 Jun 2020 11:06
URI: https://umcg.studenttheses.ub.rug.nl/id/eprint/2555

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