A pilot assessment of the FloTracTM cardiac output monitoring system
- Helen Ingrid Opdam,
- Li Wan,
- Rinaldo Bellomo
- … show all 3 hide
Rent the article at a discount
Rent now* Final gross prices may vary according to local VAT.
Get AccessAbstract
Objective
To compare measurement of cardiac output (CO) by means of the FloTracTM CO monitor with the pulmonary artery catheter (PAC).
Design
Prospective observational study.
Setting
Intensive care unit of a tertiary hospital.
Patients
Six post-operative cardiac surgery patients with existing arterial cannulas and PACs.
Interventions
Attachment of the FloTracTM CO monitor and transducer to an existing arterial cannula. Simultaneous measurements of CO, indexed to body surface area (cardiac index, CI) by the FloTracTM CO monitor and by either a bolus thermodilution or continuous CO PAC. Statistical analysis of observations.
Measurements and results
We performed CO measurements in six patients every 1–4 h after cardiac surgery. Comparison of all measurements showed a limited correlation for CI with the two devices (r 2 = 0.1218, bias = 0.21, 95% limits of agreement –0.81, 1.23). CI measurements obtained with the intermittent bolus PAC had better correlation with the FloTracTM CI values (r 2 = 0.2693, bias = –0.0057, 95% limits of agreement –1.2042, 1.1929) than did those obtained with the continuous CO PAC (r 2 = 0.0557, bias = 0.2436, 95% limits of agreement –0.7350, 1.2222).
When analysed according to heart rhythm, CI values measured during atrial pacing showed the best correlation (r 2 = 0.377, bias = –0.0244, 95% limits of agreement –0.5226, 0.5714).
Conclusions
CO measurements obtained using the FloTracTM CO monitor show a limited correlation with those acquired using the PAC, relatively wide limits of agreement but no clear bias. Further evaluation is required before this device can be recommended for use in the clinical setting.
- Swan, HJ, Ganz, W, Forrester, J, Marcus, H, Diamond, G, Chonette, D (1970) Catheterization of the heart in man with use of a flow-directed balloon-tipped catheter. N Engl J Med 283: pp. 447-451 CrossRef
- Gomez, CM, Palazzo, MG (1998) Pulmonary artery catheterization in anaesthesia and intensive care. Br J Anaesth 81: pp. 945-956
- Cholley, BP, Payen, D (2005) Noninvasive techniques for measurements of cardiac output. Curr Opin Crit Care 11: pp. 424-429 CrossRef
- McLean, AS, Needham, A, Stewart, D, Parkin, R (1997) Estimation of cardiac output by noninvasive echocardiographic techniques in the critically ill subject. Anaesth Intensive Care 25: pp. 250-254
- Rocca, G, Costa, MG, Pompei, L, Coccia, C, Pietropaoli, P (2002) Continuous and intermittent cardiac output measurement: pulmonary artery catheter versus aortic transpulmonary technique. Br J Anaesth 88: pp. 350-356 CrossRef
- Abreu, MG, Quintel, M, Ragaller, M, Albrecht, DM (1997) Partial carbon dioxide rebreathing: a reliable technique for noninvasive measurement of nonshunted pulmonary capillary blood flow. Crit Care Med 25: pp. 675-683 CrossRef
- Tan, HL, Pinder, M, Parsons, R, Roberts, B, Heerden, PV (2005) Clinical evaluation of USCOM ultrasonic cardiac output monitor in cardiac surgical patients in intensive care unit. Br J Anaesth 94: pp. 287-291 CrossRef
- Branthwaite, MA, Bradley, RD (1968) Measurement of cardiac output by thermal dilution in man. J Appl Physiol 24: pp. 434-438
- Boldt, J, Menges, T, Wollbruck, M, Hammermann, H, Hempelmann, G (1994) Is continuous cardiac output measurement using thermodilution reliable in the critically ill patient?. Crit Care Med 22: pp. 1913-1918 CrossRef
- Jacquet, L, Hanique, G, Glorieux, D, Matte, P, Goenen, M (1996) Analysis of the accuracy of continuous thermodilution cardiac output measurement. Comparison with intermittent thermodilution and Fick cardiac output measurement. Intensive Care Med 22: pp. 1125-1129
- Burchell, SA, Yu, M, Takiguchi, SA, Ohta, RM, Myers, SA (1997) Evaluation of a continuous cardiac output and mixed venous oxygen saturation catheter in critically ill surgical patients. Crit Care Med 25: pp. 388-391 CrossRef
- Medin, DL, Brown, DT, Wesley, R, Cunnion, RE, Ognibene, FP (1998) Validation of continuous thermodilution cardiac output in critically ill patients with analysis of systematic errors. J Crit Care 13: pp. 184-189 CrossRef
- Zollner, C, Goetz, AE, Weis, M, Morstedt, K, Pichler, B, Lamm, P, Kilger, E, Haller, M (2001) Continuous cardiac output measurements do not agree with conventional bolus thermodilution cardiac output determination. Can J Anaesth 48: pp. 1143-1147 CrossRef
- McGee, W, Horswell, J, Janvier, G (2005) Validation of a continuous cardiac output measurement using arterial pressure waveforms. Crit Care 9: pp. 24-25 CrossRef
- Goedje, O, Höke, K, Goetz, AE, Felbinger, TW, Reuter, DA, Reichart, B, Friedl, R, Hannekum, A, Pfeiffer, UJ (2002) Reliability of a new algorithm for continuous cardiac output determination by pulse-contour analysis during hemodynamic instability. Crit Care Med 30: pp. 52-58 CrossRef
- Pearse, RM, Ikram, K, Barry, J (2004) Equipment review: an appraisal of the LiDCO plus method of measuring cardiac output. Crit Care 8: pp. 190-195 CrossRef
- Title
- A pilot assessment of the FloTracTM cardiac output monitoring system
- Journal
-
Intensive Care Medicine
Volume 33, Issue 2 , pp 344-349
- Cover Date
- 2007-02-01
- DOI
- 10.1007/s00134-006-0410-4
- Print ISSN
- 0342-4642
- Online ISSN
- 1432-1238
- Publisher
- Springer-Verlag
- Additional Links
- Topics
- Keywords
-
- Cardiac output
- Cardiac index
- Arterial pressure
- Pulse pressure
- Pulmonary artery catheter
- Haemodynamic monitoring
- Industry Sectors
- Authors
-
- Helen Ingrid Opdam (1)
- Li Wan (1)
- Rinaldo Bellomo (1)
- Author Affiliations
-
- 1. Department of Intensive Care, Austin Hospital, VIC 3084, Heidelberg, Australia