Key result
Estimated continuous cardiac output monitoring using pulse wave transit time showed a percentage error of 46.56% and bias of -5.07 mL for stroke volume index compared to APCO.
Why the study?
Pulse wave transit time is a novel method of estimating continuous cardiac output, but few studies have evaluated it.
Does Estimated Continuous Cardiac Output Monitoring (esCCO) using Pulse Wave Transit Time (PWTT) accurately measure cardiac output compared to Arterial Pressure-based CO (APCO) in adult patients undergoing supramajor oncosurgeries?
Observational (n=50)
No
Does Estimated Continuous Cardiac Output Monitoring (esCCO) using Pulse Wave Transit Time (PWTT) accurately measure cardiac output compared to Arterial Pressure-based CO (APCO) in adult patients undergoing supramajor oncosurgeries?
esCCO using PWTT demonstrated a high percentage error (approximately 46%) when compared to APCO for measuring cardiac output parameters during major surgeries.
May lack accuracy for clinical use versus APCO; hypothesis-generating and should not yet change practice.
Background: Pulse wave transit time is a novel method of estimating continuous cardiac output (esCCO). Since there are not many studies evaluating esCCO, we compared it with arterial pressure based cardiac output (APCO) method (FloTrac). Methods: In this prospective single-center observational study, we included 50 adult patients planned to undergo supramajor oncosurgeries, where major blood loss and extensive fluid shifts were expected. Cardiac output (CO) measurements were obtained by both methods at five distinct time points, giving us 250 paired readings of stroke volume index (SVI) and cardiac index (CI). We analyzed these readings using Pearson's correlation coefficient and Bland-Altman plots, along with other appropriate statistical tests. Results: , precision of 0.74, and the limits of agreement of -1.89 and +1.01, while the percentage error was 46.29%. Bland-Altman analysis for SVI showed a bias -5.07 mL with a precision of 9.36, and the limits of agreement to be -23.4 to +13.28. The percentage error was 46.56%. Conclusion: CTRI/2019/08/020543). How to cite this article: Joshi M, Rathod R, Bhosale SJ, Kulkarni AP. Accuracy of Estimated Continuous Cardiac Output Monitoring (esCCO) Using Pulse Wave Transit Time (PWTT) Compared to Arterial Pressure-based CO (APCO) Measurement during Major Surgeries. Indian J Crit Care Med 2022;26(4):496-500.
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Kulkarni et al. (2022) conducted an observational in Supramajor oncosurgeries (n=50). Estimated Continuous Cardiac Output Monitoring (esCCO) Using Pulse Wave Transit Time (PWTT) vs. Arterial Pressure-based CO (APCO) Measurement (FloTrac) was evaluated on Stroke volume index (SVI) and cardiac index (CI) agreement. Estimated continuous cardiac output monitoring using pulse wave transit time showed a percentage error of 46.56% and bias of -5.07 mL for stroke volume index compared to APCO.
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