Key result
The BoMED NCCOM3 bioimpedance cardiac output monitor demonstrated excessive variability compared to dye dilution during induced hypotension (mean difference 0.29 +/- 0.47 l/min), lacking reliability.
Why the study?
Does the BoMed NCCOM3 bioimpedance monitor accurately measure cardiac output compared to dye dilution during induced hypotension in dogs?
Does the BoMed NCCOM3 bioimpedance monitor accurately measure cardiac output compared to dye dilution during induced hypotension in dogs?
Mean Difference: 0.29
The BoMed NCCOM3 bioimpedance cardiac output monitor is too variable and inaccurate compared to dye dilution during induced hypotension in dogs to be used as a reliable substitute.
Bioimpedance monitoring lacks reliability in canine hypotension; leaves open validation in human critical care.
Changes in thoracic electrical bioimpedance during the cardiac cycle are utilised by the BoMed NCCOM3 monitor to measure cardiac output (COTEB). The technique provides a continuous noninvasive measurement but it has not been widely accepted. To determine the accuracy of the monitor, we compared its measurement with cardiac output measured by dye dilution (CODD) during induced hypotension and recovery in 23 dogs. After calibration of the NCCOM3 monitor during a resting state in each dog [mean blood pressure 112 +/- 17 (SD), mean CODD 3.22 +/- 0.99 l/min], the mean difference (COTEB-CODD) between paired measurements at the nadir of hypotension (blood pressure 55 +/- 24 mmHg) was 0.29 +/- 0.47 l/min whose limits of agreement (mean difference +/- 2 SD) were + 111.8% and -59.1% of the mean hypotensive CODD (1.10 +/- 0.66 l/min). Upon recovery from hypotension (mean blood pressure 102 +/- 20 mmHg), the mean difference between paired measurements was -0.28 +/- 0.66 l/min, whose limits of agreement were +44.1% and -67.8% of the mean CODD (2.36 +/- 1.01 l/min). The mean difference between the two techniques is too variable and excessive to permit substitution of one technique for the other. These results do not support the accuracy and reliability of the BoMed NCCOM3 cardiac output monitor.
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Tibballs et al. (1992) studied Induced hypotension (n=23). BoMED NCCOM3 bioimpedance cardiac output monitor vs. Dye dilution was evaluated on Mean difference in cardiac output measurement at the nadir of hypotension (MD 0.29 l/min). The BoMED NCCOM3 bioimpedance cardiac output monitor demonstrated excessive variability compared to dye dilution during induced hypotension (mean difference 0.29 +/- 0.47 l/min), lacking reliability.
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