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BJA Advance Access originally published online on July 12, 2007
British Journal of Anaesthesia 2007 99(3):329-336; doi:10.1093/bja/aem188
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© The Board of Management and Trustees of the British Journal of Anaesthesia 2007. All rights reserved. For Permissions, please e-mail: journals.permissions@oxfordjournals.org

Clinical evaluation of the FloTrac/VigileoTM system and two established continuous cardiac output monitoring devices in patients undergoing cardiac surgery{dagger},{ddagger}

D. Button1, L. Weibel1, O. Reuthebuch2, M. Genoni2, A. Zollinger1 and C. K. Hofer1,*

1 Institute of Anaesthesiology and Intensive Care Medicine, Triemli City Hospital Zurich, Zurich, Switzerland
2 Division of Cardiac Surgery, Triemli City Hospital Zurich and Clinic of Cardiac Surgery, University Hospital Zurich, Zurich, Switzerland

* Corresponding author: Institute of Anesthesiology and Intensive Care Medicine, Triemli City Hospital Zurich, Birmensdorferstr. 497, 8063 Zurich, Switzerland. E-mail: christoph.hofer{at}triemli.stzh.ch

Background: Assessment of cardiac output (CO) by the FloTrac/VigileoTM system may offer a less invasive means of determining the CO than either the pulmonary artery catheter (PAC) or the PiCCOplusTM system. The aim of this study was to compare CO measurements made using the FloTrac/VigileoTM system with upgraded software (FCO, Edwards Lifesciences, Irvine CA, USA), the PiCCOplusTM system (PCO, Pulsion Medical Systems, Munich, Germany) and continuous CO monitoring using a PAC (CCO; VigilanceTM monitoring, Edwards Lifesciences, Irvine CA, USA) with intermittent pulmonary artery thermodilution (ICO). The study was conducted in patients undergoing elective cardiac surgery.

Methods: Thirty-one patients with preserved left ventricular function were enrolled. CCO, FCO, and PCO were recorded in the perioperative period at six predefined time points after achieving stable haemodynamic conditions; ICO was determined from the mean of three bolus injections. Bland–Altman analysis was used to compare CCO, FCO, and PCO with ICO.

Results: Bland–Altman analysis revealed a comparable mean bias and limits of agreement for all tested continuous CO monitoring devices using ICO as reference method. Agreement for all devices decreased in the postoperative period.

Conclusion: The performance of the FloTrac/VigileoTM system, the PiCCOplusTM, and the VigilanceTM CCO monitoring for CO measurement were comparable when tested against intermittent thermodilution in patients undergoing elective cardiac surgery.

Keywords: heart, cardiac output; measurement techniques, cardiac ouput; measurement techniques, thermodilution

{dagger} Declaration of interest. This study was supported by a research grant from Edwards Lifesciences, Irvine, CA, USA. The Institute of Anaesthesiology and Intensive Care Medicine, Triemli City Hospital has existing research grants from Pulsion Medical Systems, Munich, Germany and Edwards Lifesciences. C.K.H. has received lecture fees from both companies, Pulsion Medical Systems, Munich, Germany and Edwards Lifesciences, in the past.

{ddagger} This article is accompanied by Editorial I.


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