Department of Anesthesiology, Osaka City University Graduate School of Medicine, Osaka City, Osaka, Japan.
Department of Anesthesiology, Osaka City University Graduate School of Medicine, Osaka City, Osaka, Japan.
J Cardiothorac Vasc Anesth. 2021 Jun;35(6):1782-1791. doi: 10.1053/j.jvca.2020.11.011. Epub 2020 Nov 12.
To assess the effect of systemic vascular resistance (SVR) on the reliability of the ClearSight system (Edwards Lifesciences, Irvine, CA) for measuring blood pressure (BP) and cardiac output (CO).
Observational study.
University hospital.
Twenty-five patients undergoing cardiac surgery.
None.
BP, measured using ClearSight and an arterial line, and CO, measured using ClearSight and a pulmonary artery catheter, were recorded before (T1) and two minutes after phenylephrine or ephedrine administration. Bland-Altman analysis was used to compare BP and CO measurements at T1. A polar plot was used to assess trending abilities. Patients were divided into the following three groups according to the SVR index (SVRI) at T1: low (<1,200 dyne s/cm/m), normal (1,200-25,00 dyne s/cm/m), and high (>2,500 dyne s/cm/m). The bias in BP and CO was -4.8 ± 8.9 mmHg and 0.10 ± 0.81 L/min, respectively, which was correlated significantly with SVRI (p < 0.05). The percentage error in CO was 40.6%, which was lower in the normal SVRI group (33.3%) than the low and high groups (46.3% and 47.7%, respectively). The angular concordance rate was 96.3% and 95.4% for BP and 87.0% and 92.5% for CO after phenylephrine and ephedrine administration, respectively. There was a low tracking ability for CO changes after phenylephrine administration in the low-SVRI group (angular concordance rate 33.3%).
The ClearSight system showed an acceptable accuracy in measuring BP and tracking BP changes in various SVR states; however, the accuracy of CO measurement and its trending ability in various SVR states was poor.
评估全身血管阻力（SVR）对 ClearSight 系统（爱德华兹生命科学公司，欧文，加利福尼亚州）测量血压（BP）和心输出量（CO）的可靠性的影响。
观察性研究。
大学医院。
接受心脏手术的 25 名患者。
无。
在使用苯肾上腺素或麻黄碱给药前（T1）和给药后两分钟，使用 ClearSight 和动脉导管测量 BP，并使用 ClearSight 和肺动脉导管测量 CO。使用 Bland-Altman 分析比较 T1 时的 BP 和 CO 测量值。使用极坐标图评估趋势能力。根据 T1 时的 SVR 指数（SVRI）将患者分为以下三组：低（<1,200 迪恩·s/cm/m）、正常（1,200-25,00 迪恩·s/cm/m）和高（>2,500 迪恩·s/cm/m）。BP 和 CO 的偏差分别为-4.8 ± 8.9 mmHg 和 0.10 ± 0.81 L/min，与 SVRI 显著相关（p < 0.05）。CO 的误差百分比为 40.6%，正常 SVRI 组（33.3%）低于低和高 SVRI 组（分别为 46.3%和 47.7%）。苯肾上腺素和麻黄碱给药后，BP 的角一致性率分别为 96.3%和 95.4%，CO 分别为 87.0%和 92.5%。苯肾上腺素给药后，低 SVRI 组 CO 变化的跟踪能力较低（角一致性率为 33.3%）。
ClearSight 系统在测量 BP 和跟踪各种 SVR 状态下的 BP 变化方面具有可接受的准确性；然而，CO 测量的准确性及其在各种 SVR 状态下的趋势能力较差。
