Power Paul, Bone Allison, Simpson Nicholas, Yap Cheng-Hon, Gower Simon, Bailey Michael
Intensive Care Unit, University Hospital Geelong, Barwon Health, Geelong, Victoria, Australia.
Deakin University School of Medicine, Barwon Health, Geelong, Victoria, Australia.
Int J Crit Illn Inj Sci. 2017 Jul-Sep;7(3):156-162. doi: 10.4103/2229-5151.214411.
The aim of this trial was to determine whether Flotrac Vigileo™ (FV™) provides a reliable representation of the hemodynamic state of a cardiac surgical patient population when compared to pulmonary artery catheter (PAC) and echocardiography in the peril-operative period.
This was a prospective observational trial comparing perioperative hemodynamic states using transesophageal echocardiography (TEE), transthoracic echocardiography (TTE), FV™ and PAC during and post cardiothoracic surgery.
Tertiary regional hospital Intensive Care Unit (ICU).
50 consecutive adult cardiothoracic patients with written consent provided.
Comparison of the perioperative hemodynamic states using echocardiography, FV™ and PAC was performed. Evaluation of the hemodynamic state (HDS) was performed using TEE, TTE, PAC and FV™ during and after cardiac surgery. Data were compared between the three hemodynamic assessment modalities.
Predicted hemodynamic state.
FV™ and PAC were shown to correlate poorly with TEE/TTE assessment of the hemodynamic state. Both PAC and FV™ showed significant discordance with echocardiographic assessment of the hemodynamic state.
In this trial, FV™ and PAC were shown to agree poorly with TTE/TEE assessment of the HDS in an adult cardiothoracic population. Agreement between the FV™ and PAC was also poor. Caution is recommended in interpreting isolated hemodynamic monitoring data. All hemodynamic monitoring devices have inherent sources of error. Caution is advised in interpreting any single device or measurement as a gold standard. We suggest that hemodynamic measuring devices such as FV™/PAC may act as triggers for a global hemodynamic assessment including consideration of TTE/TEE.
本试验旨在确定与肺动脉导管（PAC）和超声心动图相比，在心脏手术患者围手术期，弗洛特拉克监护仪（FV™）能否可靠地反映血流动力学状态。
这是一项前瞻性观察性试验，比较心脏胸外科手术期间及术后使用经食管超声心动图（TEE）、经胸超声心动图（TTE）、FV™和PAC评估围手术期血流动力学状态。
三级区域医院重症监护病房（ICU）。
50例连续的成年心脏胸外科患者，并获得书面同意。
使用超声心动图、FV™和PAC比较围手术期血流动力学状态。在心脏手术期间及术后，使用TEE、TTE、PAC和FV™评估血流动力学状态（HDS）。比较三种血流动力学评估方式的数据。
预测的血流动力学状态。
FV™和PAC与TEE/TTE对血流动力学状态的评估相关性较差。PAC和FV™与超声心动图对血流动力学状态的评估均存在显著差异。
在本试验中，FV™和PAC与成年心脏胸外科患者TTE/TEE对HDS的评估一致性较差。FV™和PAC之间的一致性也较差。建议在解释单独的血流动力学监测数据时谨慎。所有血流动力学监测设备都有固有的误差来源。建议谨慎将任何单一设备或测量结果视为金标准。我们建议，FV™/PAC等血流动力学测量设备可作为全面血流动力学评估的触发因素，包括考虑TTE/TEE。
