在血液透析中使用分流侧脉搏血氧饱和度监测仪估计连续心输出量测量的可靠性和益处。

Reliability and benefit of estimated continuous cardiac output measurement using shunt-side SpO monitor in hemodialysis.

作者信息

Nakai Koji, Hirate Yuichi, Nakajima Takashi, Doi Atsushi, Hiramatsu Takeyuki, Higaki Toshie, Nakai Aiko

机构信息

College of Life and Health Sciences, Department of Clinical Engineering, Chubu University, Kasugai, Japan.

Department of Nephrology, Nagoya Ekisaikai Hospital, Nagoya, Japan.

出版信息

Ther Apher Dial. 2025 Feb;29(1):61-69. doi: 10.1111/1744-9987.14193. Epub 2024 Aug 11.

INTRODUCTION

Estimated continuous cardiac output (esCCO) is a novel technology that enables non-invasive and continuous monitoring of cardiac output. We compared the concordance in accuracies among esCCO measurements in the shunt limb and non-shunt limb.

METHODS

In this single-center prospective observational study, we include Japanese patients who underwent dialysis at our center between April 27, 2021, and February 28, 2023. Clinical accuracy of esCCO was evaluated in the shunted and non-shunted bilateral digits. Agreement between the measurements was analyzed using Lin's congruent correlation and Bland-Altman analysis.

RESULTS

For 43 individuals, Lin's concordance correlation coefficient was 0.9887 (95% confidence interval of 0.9886-0.9887) indicating good agreement. The values of esCCO measured in the shunt and non-shunt limbs were compatible. The percentage errors for the 43 patients with arterio-venous fistula (AVF) or arterio-venous graft (AVG), 32 with AVF, and 11 with AVG were 9.3%, 9.3%, and 8.9%, respectively.

CONCLUSION

esCCO could be used in shunt as well as non-shunt limbs during dialysis, allowing continuous and non-invasive hemodynamic monitoring.

引言

估计连续心输出量（esCCO）是一项能够对心输出量进行无创连续监测的新技术。我们比较了分流肢体和非分流肢体中esCCO测量准确性的一致性。

方法

在这项单中心前瞻性观察性研究中，我们纳入了2021年4月27日至2023年2月28日期间在我们中心接受透析的日本患者。在分流和未分流的双侧手指中评估esCCO的临床准确性。使用林氏一致性相关性和布兰德-奥特曼分析来分析测量值之间的一致性。

结果

对于43名个体，林氏一致性相关系数为0.9887（95%置信区间为0.9886 - 0.9887），表明一致性良好。在分流肢体和非分流肢体中测量的esCCO值是相符的。43例动静脉内瘘（AVF）或动静脉移植物（AVG）患者，其中32例为AVF，11例为AVG，其百分比误差分别为9.3%、9.3%和8.9%。