Department of Anaesthesiology and Intensive Care, Zaans Medical Centre, Koningin Julianaplein 58, 1502 DV Zaandam, The Netherlands.
Br J Anaesth. 2014 Apr;112(4):626-37. doi: 10.1093/bja/aet429. Epub 2014 Jan 14.
The FloTrac/Vigileo™, introduced in 2005, uses arterial pressure waveform analysis to calculate cardiac output (CO) and stroke volume variation (SVV) without external calibration. The aim of this systematic review is to evaluate the performance of the system. Sixty-five full manuscripts on validation of CO measurements in humans, published in English, were retrieved; these included 2234 patients and 44,592 observations.
have been analysed according to underlying patient conditions, that is, general critical illness and surgery as normodynamic conditions, cardiac and (post)cardiac surgery as hypodynamic conditions, and liver surgery and sepsis as hyperdynamic conditions, and subsequently released software versions. Eight studies compared SVV with other dynamic indices. CO, bias, precision, %error, correlation, and concordance differed among underlying conditions, subsequent software versions, and their interactions, suggesting increasing accuracy and precision, particularly in hypo- and normodynamic conditions. The bias and the trending capacity remain dependent on (changes in) vascular tone with most recent software. The SVV only moderately agreed with other dynamic indices, although it was helpful in predicting fluid responsiveness in 85% of studies addressing this. Since its introduction, the performance of uncalibrated FloTrac/Vigileo™ has improved particularly in hypo- and normodynamic conditions. A %error at or below 30% with most recent software allows sufficiently accurate and precise CO measurements and trending for routine clinical use in normo- and hypodynamic conditions, in the absence of large changes in vascular tone. The SVV may usefully supplement these measurements.
FloTrac/Vigileo™ 于 2005 年推出，使用动脉压力波形分析来计算心输出量（CO）和每搏变异度（SVV），而无需外部校准。本系统评价的目的是评估该系统的性能。共检索到 65 篇关于 CO 测量在人类中验证的英文全文文献，共纳入 2234 例患者和 44592 次观察。
根据基础患者情况进行了分析，即一般危重病和手术作为正常动力学条件，心脏和（术后）心脏手术作为低动力条件，以及肝手术和脓毒症作为高动力条件，并随后发布了软件版本。八项研究比较了 SVV 与其他动态指标。CO、偏差、精密度、%误差、相关性和一致性在基础条件、后续软件版本及其相互作用之间存在差异，提示准确性和精密度提高，尤其是在低动力和正常动力条件下。偏倚和趋势能力仍然依赖于（血管张力的变化），最新的软件也是如此。SVV 与其他动态指标的一致性仅为中等，但在 85%的研究中有助于预测液体反应性。自推出以来，未校准的 FloTrac/Vigileo™ 的性能，特别是在低动力和正常动力条件下得到了改善。最近的软件的%误差在 30%或以下允许在正常和低动力条件下进行足够准确和精确的 CO 测量和趋势分析，而血管张力无大变化。SVV 可能有助于补充这些测量。
