Park Jaehee, Choi Byung-Moon
Department of Anesthesiology and Pain Medicine, Severance Hospital, Yonsei University College of Medicine, Seoul, Korea.
Department of Anesthesiology and Pain Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea.
Acute Crit Care. 2024 Nov;39(4):565-572. doi: 10.4266/acc.2024.00731. Epub 2024 Nov 18.
A non-invasive method of measuring cardiac output (CO) can be beneficial in the care of critically ill patients. HemoVista (BiLab Co., Ltd.) is a medical device that measures CO non-invasively using multi-channel impedance plethysmography technology. The purpose of this study was to exploratively evaluate the performance of HemoVista in critically ill patients undergoing CO monitoring with the FloTrac (Edwards Lifesciences).
After non-invasively installing the HemoVista sensor in critically ill patients whose CO was monitored with the FloTrac, CO values measured by both devices were collected for 30 minutes. Cardiac output measured by both devices was selected every 10 seconds, creating approximately 360 data pairs per patient. Linear correlation analysis with Pearson correlation coefficients, Bland-Altman analysis, and four-quadrant plot analysis were performed to evaluate the performance of HemoVista.
A total of 7,138 pairs of CO data from the 20 patients were included in the analysis. A significant correlation was observed between the two methods of measuring CO (Pearson's r=0.489, P<0.001). The mean bias was 1.03 L/min, the 95% CI for the limit of agreement was -1.83 L/min to 3.93 L/min and the percentage error was 55.8%. The concordance rate of time-dependent CO between the two devices was 14.6%.
It was observed that the current version of HemoVista has unsuitable performance for use in intensive care units. To be used for critically ill patients, the algorithm must be improved and reevaluated with an enhanced version.
一种测量心输出量（CO）的非侵入性方法可能对危重症患者的护理有益。HemoVista（BiLab有限公司）是一种使用多通道阻抗容积描记技术非侵入性测量CO的医疗设备。本研究的目的是探索性评估HemoVista在使用FloTrac（爱德华生命科学公司）进行CO监测的危重症患者中的性能。
在使用FloTrac监测CO的危重症患者中无创安装HemoVista传感器后，收集两种设备测量的CO值30分钟。每10秒选择两种设备测量的心输出量，每位患者产生约360个数据对。进行Pearson相关系数的线性相关分析、Bland-Altman分析和四象限图分析以评估HemoVista的性能。
分析纳入了来自20名患者的总共7138对CO数据。观察到两种测量CO的方法之间存在显著相关性（Pearson's r = 0.489，P < 0.001）。平均偏差为1.03 L/min，一致性界限的95% CI为-1.83 L/min至3.93 L/min，百分比误差为55.8%。两种设备之间时间依赖性CO的一致率为14.6%。
观察到当前版本的HemoVista在重症监护病房使用时性能不合适。要用于危重症患者，必须改进算法并使用增强版本重新评估。
