Shah Shagun Bhatia, Bhargava Ajay Kumar, Hariharan Uma, Vishvakarma Gayatri, Jain Chamound Raj, Kansal Anamica
Rajiv Gandhi Cancer Institute and Research Centre, New Delhi, India.
Department of Anaesthesia, Dr. Ram Manohar Lohia Hospital and PGIMER, CHS, New Delhi, India.
Indian J Anaesth. 2018 Aug;62(8):584-591. doi: 10.4103/ija.IJA_783_17.
Capstesia is a software designed for smartphones (Android/iOS) to estimate the cardiac output and other haemodynamic variables from the waveform obtained from an invasive arterial cannula. The technology has been validated by studies in simulated environmental conditions. We compared the cardiac output (CO) and stroke volume variation (SVV) obtained by conventional cardiac output monitor Vigileo with CO and pulse pressure variation (PPV) extracted from Capstesia, under clinical conditions, intraoperatively.
In a Samsung smartphone in which the Capstesia software had been downloaded, the application was opened and a snapshot of the arterial waveform from the monitor screen of anaesthesia workstation was taken. The application instantaneously calculates the CO and PPV after inputting the heart rate and the systolic and diastolic blood pressure variables. These values were then compared with readings from the Vigileo monitor. Data was collected from 53 patients and analysed.
Five hundred and thirty data pairs of CO and an equal number of SVV and PPV pairs were analysed. Cardiac index by Capstesia (CIcap) was found to have a positive correlation with cardiac index by Vigileo (CIvig) using the intraclass correlation for raters, the strength of correlation being 0.757. Upper and lower 95% confidence limits were 1.43 l/min/m and - 1.14 l/min/m (Bland Altman's plot). A positive correlation was found between SVV and PPV using the Pearson's correlation ( = 0.732).
Capstesia is a reliable and feasible alternative to Vigileo for intraoperative CO monitoring in oncosurgical patients.
Capstesia是一款为智能手机（安卓/iOS）设计的软件，用于根据有创动脉插管获取的波形估算心输出量及其他血流动力学变量。该技术已在模拟环境条件下的研究中得到验证。我们在临床条件下，于术中比较了传统心输出量监测仪Vigileo测得的心输出量（CO）和每搏量变异度（SVV）与从Capstesia提取的CO和脉压变异度（PPV）。
在一部已下载Capstesia软件的三星智能手机中，打开应用程序，并从麻醉工作站的监测屏幕上截取动脉波形的快照。输入心率、收缩压和舒张压变量后，该应用程序会立即计算出CO和PPV。然后将这些值与Vigileo监测仪的读数进行比较。收集了53例患者的数据并进行分析。
分析了530组CO数据对以及数量相等的SVV和PPV数据对。使用评价者组内相关性发现，Capstesia测得的心脏指数（CIcap）与Vigileo测得的心脏指数（CIvig）呈正相关，相关强度为0.757。95%置信区间的上限和下限分别为1.43升/分钟/平方米和 - 1.14升/分钟/平方米（Bland Altman图）。使用Pearson相关性发现SVV和PPV之间呈正相关（ = 0.732）。
对于肿瘤手术患者术中的CO监测，Capstesia是Vigileo的一种可靠且可行的替代方案。
