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Stroke volume index assessment using two minimal invasive devices during hemodynamic postoperative optimization

Introduction

Postoperative hemodynamic optimization has been proved to reduce morbidity in high-risk patients [1]. Nowadays stroke volume index (SVI) monitoring is available with different less invasive techniques that have shown different levels of agreement and precision with the pulmonary artery catheter [2]. The aim of this study was to evaluate agreement and precision between SVI obtained with a calibrated (LiDCOâ„¢plus; LiDCO Ltd, Cambridge, UK) and an uncalibrated pulse contour analysis device (FloTrac/Vigileo; Edwards Lifesciences, Irvine, CA, USA), in patients undergoing postoperative hemodynamic optimization.

Methods

Patients undergoing a hemodynamic optimization protocolized care according to a previous published trial [1] to reach an oxygen delivery index >600 ml/minute/m2 after abdominal surgery were enrolled. After calibration of the LiDCOâ„¢plus, SVI data obtained from LiDCOâ„¢plus, and FloTrac/Vigileo (version 1.07) were recorded every 15 minutes for 6 hours. Agreement and precision between SVI obtained with LiDCO (SVILI) and SVI obtained with Vigileo (SVIFT) were evaluated with Bland and Altman analysis.

Results

Thirteen patients (nine males, four females), mean age 68.5 (± 28.3) years were enrolled into the study. Two hundred and seventy SVI data pairs were analyzed. Bias was 1.79 ml/m2, with a precision (1.96SD of the bias) of 25.1 ml/m2 (Figure 1).

Figure 1
figure 1

Bland and Altman analysis.

Conclusions

SVI obtained from the uncalibrated low-invasive, pulse contour analysis technique seems as accurate as the calibrated technique in a clinical hemodynamic protocolized setting to increase oxygen delivery in postoperative high-risk patients.

References

  1. Pearse R, et al: Crit Care. 2005, 9: R687-R693. 10.1186/cc3887.

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  2. Hofer CK, et al: Curr Opin Crit Care. 2007, 13: 308-331. 10.1097/MCC.0b013e3280c56afb.

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Costa, M., Cecconet, T., Chiarandini, P. et al. Stroke volume index assessment using two minimal invasive devices during hemodynamic postoperative optimization. Crit Care 14 (Suppl 1), P111 (2010). https://doi.org/10.1186/cc8343

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