Masato Nakasuji1, Aki Okutani2, Taeko Miyata3, Norie Imanaka4, Masuji Tanaka5, Kae Nakasuji6, Miwako Nagai7. 1. Department of Anesthesiology, Kansai Electric Power Hospital, 2-1-7 Fukushima, Fukushima-ku, Osaka, 553-0003, Japan; Division of Anesthesiology and Critical Care Medicine, Kansai Electric Power Medical Research Institute, 2-1-7 Fukushima, Fukushima-ku, Osaka, 553-0003, Japan. Electronic address: nakasuji.masato@c3.kepco.co.jp. 2. Department of Anesthesiology, Kansai Electric Power Hospital, 2-1-7 Fukushima, Fukushima-ku, Osaka, 553-0003, Japan. Electronic address: kawasaki.aki@b2.kepco.co.jp. 3. Department of Anesthesiology, Kansai Electric Power Hospital, 2-1-7 Fukushima, Fukushima-ku, Osaka, 553-0003, Japan. Electronic address: miyata.taeko@a2.kepco.co.jp. 4. Department of Anesthesiology, Kansai Electric Power Hospital, 2-1-7 Fukushima, Fukushima-ku, Osaka, 553-0003, Japan. Electronic address: imanaka.norie@d3.kepco.co.jp. 5. Department of Anesthesiology, Kansai Electric Power Hospital, 2-1-7 Fukushima, Fukushima-ku, Osaka, 553-0003, Japan. Electronic address: tanaka.masuji@e2.kepco.co.jp. 6. Department of Anesthesiology, Kansai Electric Power Hospital, 2-1-7 Fukushima, Fukushima-ku, Osaka, 553-0003, Japan. Electronic address: kae-fuku@rb3.so-net.ne.jp. 7. Department of Anesthesiology, Kansai Electric Power Hospital, 2-1-7 Fukushima, Fukushima-ku, Osaka, 553-0003, Japan. Electronic address: yoshioka.miwako@e3.kepco.co.jp.
Abstract
STUDY OBJECTIVE: To determine the agreement between cardiac output (CO) and stroke volume variation (SVV) measured simultaneously by the fourth generation FloTrac/Vigileo system and LiDCOrapid system during pneumoperitoneum in patients undergoing laparoscopic colectomy. DESIGN: Retrospective observational study. SETTINGS: Operating room in a general hospital. PATIENTS: Ten patients (American Society of Anesthesiologist 1 or 2) without preoperative anemia. INTERVENTIONS: A 22-gauge catheter was inserted in the radial artery after induction of anesthesia. The arterial line was split to monitor CO and SVV simultaneously with the LiDCOrapid and fourth generation FloTrac/Vigileo systems. All data were downloaded from each system after surgery and simultaneous paired COFloTrac, COLiDCO and SVVFloTrac, SVVLiDCO values estimated every 1 minute during the pneumoperitoneum were analyzed. MEASUREMENTS: To assess the agreement after carbon dioxide insufflation, a scatter 4-quadrant plot was generated using paired ΔCO values (changes in COFloTrac and COLiDCO just before pneumoperitoneum and 3 minutes after the induction of pneumoperitoneum). For data in which SVVFloTrac was >9% but <16% and cardiac index measured by FloTrac/Vigileo was <2.5 L/min per m2 during stable pneumoperitoneum (the period from 5 minutes after Trendelenburg position until discontinuation of pneumoperitoneum), simultaneously measured paired SVVFloTrac and SVVLiDCO were plotted every 1 minute using the Bland-Altman method. MAIN RESULTS: A concordance ratio for changes in CO after the induction of pneumoperitoneum was 83% in 4-quadrant plot. During stable pneumoperitoneum, 702 paired SVVFloTrac and SVVLiDCO matched the criteria. These data sets were plotted by the Bland-Altman method and the bias and 95% limit of agreement of SVV were 2.01 and -2.63% to 6.65%, respectively, with 38% percentage error. The regression equation was SVVLiDCO = 0.98 × SVVFloTrac- 1.73 with Pearson correlation coefficient of 0.55. CONCLUSIONS: Our study showed disagreement between the 2 methods and the hemodynamic parameters measured by one of the two devices should be interpreted with caution before therapeutic interventions.
STUDY OBJECTIVE: To determine the agreement between cardiac output (CO) and stroke volume variation (SVV) measured simultaneously by the fourth generation FloTrac/Vigileo system and LiDCOrapid system during pneumoperitoneum in patients undergoing laparoscopic colectomy. DESIGN: Retrospective observational study. SETTINGS: Operating room in a general hospital. PATIENTS: Ten patients (American Society of Anesthesiologist 1 or 2) without preoperative anemia. INTERVENTIONS: A 22-gauge catheter was inserted in the radial artery after induction of anesthesia. The arterial line was split to monitor CO and SVV simultaneously with the LiDCOrapid and fourth generation FloTrac/Vigileo systems. All data were downloaded from each system after surgery and simultaneous paired COFloTrac, COLiDCO and SVVFloTrac, SVVLiDCO values estimated every 1 minute during the pneumoperitoneum were analyzed. MEASUREMENTS: To assess the agreement after carbon dioxide insufflation, a scatter 4-quadrant plot was generated using paired ΔCO values (changes in COFloTrac and COLiDCO just before pneumoperitoneum and 3 minutes after the induction of pneumoperitoneum). For data in which SVVFloTrac was >9% but <16% and cardiac index measured by FloTrac/Vigileo was <2.5 L/min per m2 during stable pneumoperitoneum (the period from 5 minutes after Trendelenburg position until discontinuation of pneumoperitoneum), simultaneously measured paired SVVFloTrac and SVVLiDCO were plotted every 1 minute using the Bland-Altman method. MAIN RESULTS: A concordance ratio for changes in CO after the induction of pneumoperitoneum was 83% in 4-quadrant plot. During stable pneumoperitoneum, 702 paired SVVFloTrac and SVVLiDCO matched the criteria. These data sets were plotted by the Bland-Altman method and the bias and 95% limit of agreement of SVV were 2.01 and -2.63% to 6.65%, respectively, with 38% percentage error. The regression equation was SVVLiDCO = 0.98 × SVVFloTrac- 1.73 with Pearson correlation coefficient of 0.55. CONCLUSIONS: Our study showed disagreement between the 2 methods and the hemodynamic parameters measured by one of the two devices should be interpreted with caution before therapeutic interventions.
Authors: Issa Pour-Ghaz; Theodore Manolukas; Nathalie Foray; Joel Raja; Aranyak Rawal; Uzoma N Ibebuogu; Rami N Khouzam Journal: Ann Transl Med Date: 2019-09