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GE E-PiCCO 衍生的血流动力学参数与 PiCCO® 在重症监护病房患者中的比较。

Accuracy of hemodynamic parameters derived by GE E-PiCCO in comparison with PiCCO® in patients admitted to the intensive care unit.

机构信息

Department of Internal Medicine II, School of Medicine, University Hospital rechts der Isar, Technical University of Munich, Munich, Germany.

出版信息

Sci Rep. 2023 Apr 26;13(1):6861. doi: 10.1038/s41598-023-34141-8.

Abstract

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.

摘要

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。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/618a/10133386/420b239f7eb1/41598_2023_34141_Fig1_HTML.jpg

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