Key result
The 4th generation of FloTrac did not show clinically acceptable agreement with PiCCO for assessing cardiac index (percentage error 47.4%), but demonstrated an acceptable concordance rate of 93.6% for tracking changes.
Why the study?
The accuracy and trending ability of cardiac index measured by the fourth-generation FloTrac compared with PiCCO needed evaluation in septic shock patients.
Does the 4th generation FloTrac accurately measure and track cardiac index compared to PiCCO in septic shock patients?
Observational (n=31)
No
Does the 4th generation FloTrac accurately measure and track cardiac index compared to PiCCO in septic shock patients?
Effect estimate: Bias 0.14 L/min/m2 (95% CI -1.62-1.91)
Do not interchange 4th-gen FloTrac with PiCCO for absolute CI in septic shock; leaves open adjunctive trending use.
Background/aim: FloTrac/Vigileo is a noncalibrated arterial pressure waveform analysis for cardiac index (CI) monitoring. The aim of our study was to compare the CI measured by the 4th generation of FloTrac with PiCCO in septic shock patients. Materials and methods: We simultaneously measured the CI using FloTrac (CIv) and compared it with the CI derived from transpulmonary thermodilution (CItd) as well as the pulse contour-derived CI using PiCCO (CIp). Results: Thirty-one septic shock patients were included. The CIv correlated with CItd (r = 0.62, P < 0.0001). The Bland-Altman analysis showed a bias of 0.14, and the limits of agreement were –1.62–1.91 L/min/m2 with a percentage error of 47.4%. However, the concordance rate between CIv and CItd was 93.6%. The comparison of CIv with CIp (n = 352 paired measurements) revealed a bias of -0.16, and the limits of agreement were –1.45–1.79 L/min/m2 with a percentage error of 44.8%. The overall correlation coefficient between CIv and CIp was 0.63 (P < 0.0001), and the concordance rate was 85.4%. Conclusion: The 4th generation of FloTrac has not acceptable agreement to assess CI; however, it has the ability to tracked changes of CI, when compared with the transpulmonary thermodilution method by PiCCO.
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Khwannimit et al. (2020) conducted an observational in Septic shock (n=31). 4th generation FloTrac vs. PiCCO (transpulmonary thermodilution and pulse contour analysis) was evaluated on Agreement between cardiac index measured by FloTrac (CIv) and transpulmonary thermodilution (CItd) (Bias 0.14 L/min/m2, 95% CI -1.62-1.91). The 4th generation of FloTrac did not show clinically acceptable agreement with PiCCO for assessing cardiac index (percentage error 47.4%), but demonstrated an acceptable concordance rate of 93.6% for tracking changes.
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