Dache Stephanie, Van Rompaey Nicolas, Joosten Alexandre, Desebbe Olivier, Saxena Sarah, Eynden Frederic Vanden, Van Aelbrouck Caroline, Huybrechts Isabelle, Obbergh Luc Van, Barvais Luc
Department of Anaesthesiology, Erasme University Hospital, Université Libre de Bruxelles, Brussels, Belgium.
Anaesthesiol Intensive Ther. 2017;49(3):175-180. doi: 10.5603/AIT.2017.0043.
Cardiac output (CO) is a physiological variable that should be monitored during cardiac surgery. The purpose of this study was to assess the trending ability of two CO monitors, esCCO (Nihon Kohden™, Tokyo, Japan) and Volume View (VV) (Edwards Lifesciences, Irvine, USA).
A total of 19 patients were included in the study. Before cardiopulmonary bypass (CPB), CO was measured simultaneously using both esCCO and VV devices before and after three CO-modifying manoeuvres (passive leg raise [PLR], the end expiratory occlusion test [EEOT] and positive end expiratory pressure [PEEP] at 10 cm H₂O). Five CO values for esCCO and three for VV were averaged and compared during a one-minute period of time before and after each manoeuvre.
A total of 114 paired readings were collected. Median CO values were 4.3 L min⁻¹ (IQR: 3.8; 5.2) and 3.8 L min⁻¹ (IQR: 3.5; 4.5) for esCCO and VV, respectively. The precision error was 1.4% (95% CI:1.0-1.7) for esCCO and 2.2% (95% CI: 1.8-2.7) for VV. The bias between esCCO and VV values was normally distributed (P = 0.0596). Between esCCO and VV, the mean bias was +0.6 L min⁻¹ with a Limit of Agreement (LOA) of -1.8 L min⁻¹ and +3.0 L min⁻¹. The concordance rate was 43% (95% CI: 29-58) between esCCO and VV.
Both single and trended measurements of CO using esCCO and VV were not in agreement. This large discrepancy leads one to the conclusion that any outcome study conducted with one of these devices cannot be applied to the other.
心输出量（CO）是心脏手术期间应监测的生理变量。本研究的目的是评估两种心输出量监测仪，即esCCO（日本光电株式会社，东京，日本）和容积视图（VV）（爱德华生命科学公司，尔湾，美国）的趋势监测能力。
本研究共纳入19例患者。在体外循环（CPB）前，在三种改变心输出量的操作（被动抬腿[PLR]、呼气末阻断试验[EEOT]和10 cm H₂O的呼气末正压[PEEP]）前后，同时使用esCCO和VV设备测量心输出量。在每次操作前后的一分钟内，对esCCO的五个心输出量值和VV的三个心输出量值进行平均并比较。
共收集了114对读数。esCCO和VV的心输出量中位数分别为4.3 L min⁻¹（四分位间距：3.8；5.2）和3.8 L min⁻¹（四分位间距：3.5；4.5）。esCCO的精确误差为1.4%（95%置信区间：1.0 - 1.7），VV的精确误差为2.2%（95%置信区间：1.8 - 2.7）。esCCO和VV值之间的偏差呈正态分布（P = 0.0596）。在esCCO和VV之间，平均偏差为 +0.6 L min⁻¹，一致性界限（LOA）为 -1.8 L min⁻¹和 +3.0 L min⁻¹。esCCO和VV之间的一致率为43%（95%置信区间：29 - 58）。
使用esCCO和VV进行的心输出量单次测量和趋势测量均不一致。这种巨大差异导致得出这样的结论：使用其中一种设备进行的任何结果研究都不能应用于另一种设备。
