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Validation of cardiac output from Mostcare compared with a pulmonary artery catheter in septic patients

Introduction

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 [1].

Methods

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.

Results

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.

Figure 1
figure 1

Cardiac output Bland-Altman analysis.

Conclusion

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.

References

  1. 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 (Suppl 1), P140 (2014). https://doi.org/10.1186/cc13330

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  • DOI: https://doi.org/10.1186/cc13330

Keywords

  • Cardiac Output
  • Septic Shock
  • Severe Sepsis
  • Percentage Error
  • Pulmonary Artery Catheter