Department of Internal Medicine II, School of Medicine, University Hospital rechts der Isar, Technical University of Munich, Munich, Germany.
Sci Rep. 2023 Apr 26;13(1):6861. doi: 10.1038/s41598-023-34141-8.
To evaluate the agreement and accuracy of a novel advanced hemodynamic monitoring (AHM) device, the GE E-PiCCO module, with the well-established PiCCO® device in intensive care patients using pulse contour analysis (PCA) and transpulmonary thermodilution (TPTD). A total of 108 measurements were performed in 15 patients with AHM. Each of the 27 measurement sequences (one to four per patient) consisted of a femoral and a jugular indicator injection via central venous catheters (CVC) and measurement using both PiCCO (PiCCO® Jug and Fem) and GE E-PiCCO (GE E-PiCCO Jug and Fem) devices. For statistical analysis, Bland-Altman plots were used to compare the estimated values derived from both devices. The cardiac index measured via PCA (CIpc) and TPTD (CItd) was the only parameter that fulfilled all a priori-defined criteria based on bias and the limits of agreement (LoA) by the Bland-Altman method as well as the percentage error by Critchley and Critchley for all three comparison pairs (GE E-PiCCO Jug vs. PiCCO® Jug, GE E-PiCCO Fem vs. PiCCO® Fem, and GE E-PiCCO Fem vs. GE E-PiCCO Jug), while the GE E-PiCCO did not accurately estimate EVLWI, SVRI, SVV, and PPV values measured via the jugular and femoral CVC compared with values assessed by PiCCO®. Consequently, measurement discrepancy should be considered on evaluation and interpretation of the hemodynamic status of patients admitted to the ICU when using the GE E-PiCCO module instead of the PiCCO® device.
为了评估新型先进血流动力学监测(AHM)设备——GE E-PiCCO 模块与经胸肺热稀释(TPTD)和脉搏轮廓分析(PCA)的成熟 PiCCO®设备的一致性和准确性,对 15 名重症监护患者进行了 108 次测量。AHM 共进行了 27 次测量序列(每个患者 1-4 次),每个序列均通过中心静脉导管(CVC)进行股静脉和颈内静脉指示剂注射,并使用 PiCCO(PiCCO® Jug 和 Fem)和 GE E-PiCCO(GE E-PiCCO Jug 和 Fem)设备进行测量。为了进行统计分析,使用 Bland-Altman 图比较两种设备得出的估计值。通过 PCA(CIpc)和 TPTD(CItd)测量的心脏指数是唯一符合所有基于偏倚和 Bland-Altman 方法的一致性界限(LoA)以及 Critchley 和 Critchley 定义的所有三个比较对(GE E-PiCCO Jug 与 PiCCO® Jug、GE E-PiCCO Fem 与 PiCCO® Fem 和 GE E-PiCCO Fem 与 GE E-PiCCO Jug)的百分比误差的参数,而 GE E-PiCCO 无法准确估计通过颈内和股静脉 CVC 测量的 EVLWI、SVRI、SVV 和 PPV 值,与 PiCCO®评估的值相比存在差异。因此,当使用 GE E-PiCCO 模块而不是 PiCCO®设备评估和解释 ICU 患者的血流动力学状态时,应考虑测量差异。