Document Detail

Uncalibrated arterial pressure waveform analysis for less-invasive cardiac output determination in obese patients undergoing cardiac surgery.
MedLine Citation:
PMID:  19482857     Owner:  NLM     Status:  MEDLINE    
BACKGROUND: Uncalibrated arterial waveform analysis (FloTrac/Vigileo) uses standard arterial access to determine cardiac output (CO). Calculations are based on arterial waveform characteristics in combination with patient characteristic data to estimate individual arterial compliance. It has been shown that obesity is associated with altered arterial compliance independently of other risk factors. We conducted this study to assess the validity of measuring CO by the FloTrac/Vigileo device in obese patients undergoing cardiac surgery in comparison with bolus thermodilution technique.
METHODS: Fifteen obese patients with a BMI of > or = 30 and 23 non-obese patients (BMI 18-25) undergoing coronary artery bypass grafting (CABG) were included. Simultaneous CO measurements by bolus thermodilution and the FloTrac/Vigileo device (software version 1.10) were obtained intraoperatively after induction of anaesthesia, before cardiopulmonary bypass (CPB), after CPB, and after sternal closure. Measurements in the intensive care unit (ICU) were performed upon arrival in the ICU, after 4, 8, and 24 h after surgery. CO was indexed to the body surface area (cardiac index, CI).
RESULTS: The analysis of 262 data pairs revealed a bias and precision of 0.19 and +/-0.66 litre min(-1) m(-2), resulting in a percentage error of 26.6%. Thermodilution CI values ranged from 1.1 to 4.2 litre min(-1) m(-2) [mean 2.4 (0.52) litre min(-1) m(-2)]. Subgroup analysis resulted in a percentage error of 29.8% in obese patients and 24.4% in patients with normal BMI.
CONCLUSIONS: The semi-invasive FloTrac/Vigileo device was found to adequately agree with bolus pulmonary artery thermodilution in both obese and non-obese patients undergoing CABG.
J Mayer; J Boldt; R Beschmann; A Stephan; S Suttner
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Publication Detail:
Type:  Evaluation Studies; Journal Article; Retracted Publication     Date:  2009-05-29
Journal Detail:
Title:  British journal of anaesthesia     Volume:  103     ISSN:  1471-6771     ISO Abbreviation:  Br J Anaesth     Publication Date:  2009 Aug 
Date Detail:
Created Date:  2009-07-14     Completed Date:  2009-08-13     Revised Date:  2011-08-10    
Medline Journal Info:
Nlm Unique ID:  0372541     Medline TA:  Br J Anaesth     Country:  England    
Other Details:
Languages:  eng     Pagination:  185-90     Citation Subset:  IM    
Department of Anaesthesiology and Intensive Care Medicine, Klinikum Ludwigshafen, Bremserstr. 79, 67063 Ludwigshafen, Germany.
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MeSH Terms
Aged, 80 and over
Blood Pressure / physiology
Body Mass Index
Cardiac Output / physiology*
Cardiopulmonary Bypass
Coronary Artery Bypass*
Middle Aged
Monitoring, Intraoperative / methods*
Obesity / physiopathology*
Radial Artery / physiopathology
Reproducibility of Results
Thermodilution / methods
Vascular Resistance / physiology
Retraction In:
Reilly C. Br J Anaesth. 2011 Jul;107(1):116-7   [PMID:  21685126 ]

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