非体外循环冠状动脉旁路移植术后通过脉搏波传播时间分析测量的心脏指数和每搏量变异与传统脉搏轮廓分析的验证：观察性研究

The Validation of Cardiac Index and Stroke-Volume Variation Measured by the Pulse-Wave Transit Time-Analysis Versus Conventional Pulse-Contour Analysis After Off-Pump Coronary Artery Bypass Grafting: Observational Study.

作者信息

Fot Evgeniia V, Smetkin Alexey A, Volkov Dmitriy A, Semenkova Tatyana N, Paromov Konstantin V, Kuzkov Vsevolod V, Kirov Mikhail Y

机构信息

Department of Anesthesiology and Intensive Care Medicine, Northern State Medical University, Arkhangelsk, Russia; Department of Anesthesiology and Intensive Care Medicine, City Hospital #1 n.a. E.E. Volosevich, Arkhangelsk, Russia.

出版信息

J Cardiothorac Vasc Anesth. 2023 Jun;37(6):919-926. doi: 10.1053/j.jvca.2023.02.010. Epub 2023 Feb 11.

DOI:10.1053/j.jvca.2023.02.010

PMID:36878818

Abstract

OBJECTIVE

To compare the reliability of cardiac index (CI) and stroke-volume variation (SVV) measured by the pulse-wave transit-time (PWTT) method using estimated continuous cardiac output (esCCO) technique with conventional pulse-contour analysis after off-pump coronary artery bypass grafting (OPCAB).

DESIGN

A single-center, prospective, observational study.

SETTING

At a 1,000-bed university hospital.

PARTICIPANTS

A total of 21 patients were enrolled after elective OPCAB.

INTERVENTIONS

The study authors performed a method comparison study with simultaneous measurement of CI and SVV based on the esCCO technique (CI and esSVV, correspondingly) and pulse-contour analysis (CI and SVV, correspondingly). As a secondary analysis, they also assessed the trending ability of CI versus CI MEASUREMENTS AND MAIN RESULTS: The authors analyzed 178 measurement pairs for CI, and 174 pairs for SVV during the 10 study stages. The mean bias between CI and CI was 0.06 L min/m, with limits of agreement of ± 0.92 L min/m and a percentage error (PE) of 35.3%. The analysis of the trending ability of CI measured by PWTT revealed a concordance rate of 70%. The mean bias between esSVV and SVV was -6.1%, with limits of agreement of ± 15.5% and a PE of 137%.

CONCLUSIONS

The overall performance of CI and esSVV versus CI and SVV is not clinically acceptable. A further improvement of the PWTT algorithm may be required for an accurate and precise assessment of CI and SVV.

摘要

目的

比较在非体外循环冠状动脉搭桥术（OPCAB）后，使用估计连续心输出量（esCCO）技术通过脉搏波传播时间（PWTT）方法测量的心脏指数（CI）和每搏量变异度（SVV）与传统脉搏轮廓分析的可靠性。

设计

单中心、前瞻性观察性研究。

地点

在一家拥有1000张床位的大学医院。

参与者

共纳入21例择期OPCAB术后患者。

干预措施

研究作者进行了一项方法比较研究，同时基于esCCO技术（相应地为CI和esSVV）和脉搏轮廓分析（相应地为CI和SVV）测量CI和SVV。作为次要分析，他们还评估了CI的趋势能力与CI的测量和主要结果：作者在10个研究阶段分析了178对CI测量值和174对SVV测量值。CI与CI之间的平均偏差为0.06L·min/m²，一致性界限为±0.92L·min/m²，百分比误差（PE）为35.3%。对通过PWTT测量的CI的趋势能力分析显示一致性率为70%。esSVV与SVV之间的平均偏差为-6.1%，一致性界限为±15.5%，PE为137%。