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Validation of cardiac output from Mostcare compared with a pulmonary artery catheter in septic patients
Critical Care volume 18, Article number: P140 (2014)
The Mostcare monitor is a non-invasive cardiac output monitor. It has been well validated in cardiac surgical patients but there is limited evidence on its use in patients with severe sepsis and septic shock .
The first 22 consecutive patients with severe sepsis and septic shock in whom the floatation of a pulmonary artery catheter was deemed necessary to guide clinical management were included. Cardiac output measurements were simultaneously calculated and recorded from a thermodilution pulmonary artery catheter and from the Mostcare monitor respectively. The two methods of measuring cardiac output were compared by Bland-Altman statistics and linear regression analysis. A percentage error less than 30% was defined as acceptable for this study.
Bland-Altman analysis for cardiac output showed a bias of 0. 31 I/minute, precision (=SD) of 1.97 l/minute and a percentage error of 62.54%. Linear regression produced a correlation coefficient r2 for cardiac output of 0.403. See Figure 1.
Compared with thermodilution cardiac output, cardiac output studies obtained from the Mostcare monitor have an unacceptably high error rate. The Mostcare monitor is not a reliable monitoring device to measure cardiac output in patients with severe sepsis and septic shock on an ICU.
Franchi F, Silvestri R, Cubattoli L, et al.: Comparison between an uncalibrated pulse contour method and thermodilution technique for cardiac output estimation in septic patients. Br J Anaesth 2011, 107: 202-208. 10.1093/bja/aer123
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Gopal, S., Pooni, J., Do, T. et al. Validation of cardiac output from Mostcare compared with a pulmonary artery catheter in septic patients. Crit Care 18, P140 (2014). https://doi.org/10.1186/cc13330
- Cardiac Output
- Septic Shock
- Severe Sepsis
- Percentage Error
- Pulmonary Artery Catheter