Does using two Doppler cardiac output monitors in tandem provide a reliable trend line of changes for validation studies?

Journal of Clinical Monitoring and Computing
Huang LiJie Zhang

Abstract

The demise of the pulmonary artery catheter as a gold standard in cardiac output measurement has created the need for new standard. Doppler cardiac output can be measured suprasternally (USCOM) and via the oesophagus (CardioQ). Use in tandem they may provide a reliable trend line of cardiac output changes against which new technologies can be assessed. Data from three similar clinical studies was pooled. Simultaneous USCOM and CardioQ readings, 13 (7-27), were performed every 15-30 min intraoperatively. Within individual patient regression analysis was performed. Data was normalized, CardioQ against USCOM, to eliminate the systematic error component following calibration. Bland-Altman and trend, concordance and polar analysis, were performed on the grouped data. Cardiac output was indexed (CI) to BSA. Data from 53 patients, aged 59 (26-81) years, scheduled for major surgery were included. Within-individual mean (SD) CI was 3.4 (0.6) L min(-1) m(-2). Correlation was good to excellent in 83 % of cases, R(2) > 0.80, and reasonable in 96 %, R(2) > 0.60. Percentage error was 38 %, and decreased to 14 % with normalization. The estimated 95 % precision for a single Doppler reading was ±10 %. Concordance rate was 96.6 % (confidence int...Continue Reading

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Citations

Nov 12, 2016·Journal of Clinical Monitoring and Computing·Lars Øivind Høiseth, Jostein S Hagemo
Jan 9, 2017·Journal of Clinical Monitoring and Computing·Bernd SaugelThomas W L Scheeren

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