The Validation of Cardiac Index and Stroke-Volume Variation Measured by the Pulse-Wave Transit Time-Analysis Versus Conventional Pulse-Contour Analysis After Off-Pump Coronary Artery Bypass Grafting: Observational Study

Evgeniia V Fot; Alexey A Smetkin; Dmitriy A Volkov; Tatyana N Semenkova; Konstantin V Paromov; Vsevolod V Kuzkov; Mikhail Y Kirov

doi:10.1053/j.jvca.2023.02.010

The Validation of Cardiac Index and Stroke-Volume Variation Measured by the Pulse-Wave Transit Time-Analysis Versus Conventional Pulse-Contour Analysis After Off-Pump Coronary Artery Bypass Grafting: Observational Study

J Cardiothorac Vasc Anesth. 2023 Jun;37(6):919-926. doi: 10.1053/j.jvca.2023.02.010. Epub 2023 Feb 11.

Authors

Evgeniia V Fot¹, Alexey A Smetkin², Dmitriy A Volkov², Tatyana N Semenkova², Konstantin V Paromov³, Vsevolod V Kuzkov², Mikhail Y Kirov²

Affiliations

¹ Department of Anesthesiology and Intensive Care Medicine, Northern State Medical University, Arkhangelsk, Russia; Department of Anesthesiology and Intensive Care Medicine, City Hospital #1 n.a. E.E. Volosevich, Arkhangelsk, Russia. Electronic address: ev_fot@mail.ru.
² Department of Anesthesiology and Intensive Care Medicine, Northern State Medical University, Arkhangelsk, Russia; Department of Anesthesiology and Intensive Care Medicine, City Hospital #1 n.a. E.E. Volosevich, Arkhangelsk, Russia.
³ Department of Anesthesiology and Intensive Care Medicine, Northern State Medical University, Arkhangelsk, Russia.

PMID: 36878818
DOI: 10.1053/j.jvca.2023.02.010

Abstract

Objective: To compare the reliability of cardiac index (CI) and stroke-volume variation (SVV) measured by the pulse-wave transit-time (PWTT) method using estimated continuous cardiac output (esCCO) technique with conventional pulse-contour analysis after off-pump coronary artery bypass grafting (OPCAB).

Design: A single-center, prospective, observational study.

Setting: At a 1,000-bed university hospital.

Participants: A total of 21 patients were enrolled after elective OPCAB.

Interventions: The study authors performed a method comparison study with simultaneous measurement of CI and SVV based on the esCCO technique (CI_esCCO and esSVV, correspondingly) and pulse-contour analysis (CI_PCA and SVV_PCA, correspondingly). As a secondary analysis, they also assessed the trending ability of CI_esCCO versus CI_PCA. MEASUREMENTS AND MAIN RESULTS: The authors analyzed 178 measurement pairs for CI, and 174 pairs for SVV during the 10 study stages. The mean bias between CI_esCCO and CI_PCA was 0.06 L min/m², with limits of agreement of ± 0.92 L min/m² and a percentage error (PE) of 35.3%. The analysis of the trending ability of CI measured by PWTT revealed a concordance rate of 70%. The mean bias between esSVV and SVV_PCA was -6.1%, with limits of agreement of ± 15.5% and a PE of 137%.

Conclusions: The overall performance of CI_esCCO and esSVV versus CI_PCA and SVV_PCA is not clinically acceptable. A further improvement of the PWTT algorithm may be required for an accurate and precise assessment of CI and SVV.

Keywords: cardiac output; off-pump coronary artery bypass grafting; pulse contour analysis; pulse wave transit time; stroke volume variation.

Publication types

Observational Study

MeSH terms

Cardiac Output
Coronary Artery Bypass, Off-Pump* / methods
Humans
Prospective Studies
Reproducibility of Results
Stroke* / diagnosis
Thermodilution / methods