J Med Assoc Thai 2020; 103 (6):541-7

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Are Noninvasive Continuous Cardiac Output Monitoring Interchangeable with Esophageal Doppler?
Pisitsak C Mail, Luetrakool P , Pisalayon M , Thamjamrassri T

Objective: To compare the trending ability, accuracy, and precision of non-invasive stroke volume (SV) measurement based on a bioreactance technique and measurement of the pulse wave transit time (PWTT) versus the esophageal Doppler monitoring (EDM).

Materials and Methods: Two hundred twenty-seven paired measurements from 10 patients who underwent abdominal surgery under general anesthesia were included for SV measurements. Pearson’s correlation coefficient was calculated, and Bland-Altman analysis was performed to evaluate the agreement between EDM and bioreactance (EDM-bioreactance) and between EDM and PWTT (EDM-PWTT).

Results: EDM-bioreactance had a correlation coefficient of 0.75 (95% confidence interval [CI] 0.62 to 0.78; p<0.001), bias of 0.28 ml (limits of agreement –30.92 to 31.38 ml), and percentage error of 46.82%. EDM-PWTT had a correlation coefficient of 0.48 (95% CI 0.44 to 0.72; p<0.001), bias of –0.18 ml (limits of agreement –40.28 to 39.92 ml), and percentage error of 60.17%. A subgroup analysis of data from patients who underwent crystalloid loading was performed to detect the trending ability. The four-quadrant plot analysis between EDM-bioreactance and EDM-PWTT demonstrated concordance rates of 70.00% and 73.68%, respectively.

Conclusion: SV measurement based on bioreactance technique and measurement of PWTT are not interchangeable with EDM.

Trial registration: Thai Clinical Trials Registry, TCTR 20181217003

Keywords: Stroke volume, Cardiac output, Doppler, Perioperative care, Pulse, Time

DOI: doi.org/10.35755/jmedassocthai.2020.06.10413

Received 2 Jul 2019 | Revised 14 Oct 2019 | Accepted 17 Oct 2019

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