Why the study?
Does uncalibrated cardiac output measurement by radial artery waveform analysis agree with measurements from the ascending aorta in patients undergoing cardiac surgery?
Does uncalibrated cardiac output measurement by radial artery waveform analysis agree with measurements from the ascending aorta in patients undergoing cardiac surgery?
Uncalibrated cardiac output measurements from radial artery waveform analysis show wide limits of agreement compared to ascending aorta measurements, suggesting they should be interpreted with caution during cardiac surgery.
Uncalibrated radial CO may not be interchangeable with aortic measurements in cardiac surgery; leaves open validation of waveform analysis against direct standards.
In cardiac surgery, perioperative haemodynamic management is often guided by cardiac output (CO) measurements. The Vigileo monitor offers uncalibrated CO measurement by arterial waveform analysis (CO(wave)). This validation study compared CO measurements derived from radial artery waveform analysis with those derived from the ascending aorta. CO measurements from the radial artery versus the ascending aorta showed a significant correlation before and after cardiopulmonary bypass (CPB). However, Bland-Altman analysis showed a mean bias of 0.1 l/min and 0.1 l/min, and limits of agreement (LOA) of +2.2 l/min and -1.9 l/min prior to CPB, and +2.5 l/min and -2.7 l/min after weaning from CPB. A comparison of these CO measurements showed a low mean bias, but wide LOA before and after CPB. Therefore measurements using uncalibrated CO(wave) have to be interpreted with caution in a clinical situation.
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Sander et al. (2008) studied this question.
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