Greiwe Gillis, Saad Rami, Hapfelmeier Alexander, Neumann Niklas, Tariparast Pischtaz, Saugel Bernd, Flick Moritz
Department of Anesthesiology, Center of Anesthesiology and Intensive Care Medicine, University Medical Center Hamburg-Eppendorf, Martinistrasse 52, 20246, Hamburg, Germany.
Institute of AI and Informatics in Medicine, TUM School of Medicine and Health, Technical University of Munich, Munich, Germany.
J Clin Monit Comput. 2025 Apr;39(2):371-376. doi: 10.1007/s10877-024-01246-y. Epub 2024 Dec 11.
Cardiac output can be estimated non-invasively by electrical cardiometry with the ICON® monitor (Osypka Medical GmbH, Berlin, Germany). Conflicting results have been reported regarding the cardiac output measurement performance of electrical cardiometry. In this prospective method comparison study, we compared cardiac output measured using electrical cardiometry (EC-CO; test method) with cardiac output measured using intermittent pulmonary artery thermodilution (PATD-CO; reference method) in patients after coronary artery bypass graft (CABG) surgery. We calculated the mean of the differences with 95%-limits of agreement (95%-LOA) and their corresponding 95%-confidence intervals (95%-CI) using Bland-Altman analysis and calculated the percentage error. We also analyzed trending using four-quadrant plot analysis. We analyzed 157 paired cardiac output measurements of 41 patients. Mean ± standard deviation PATD-CO was 5.1 ± 1.3 L/min and mean EC-CO was 5.3 ± 1.3 L/min. The mean of the differences ± SD between PATD-CO and EC-CO was -0.2 (95%-CI -0.5 to 0.2) ± 1.2 L/min with a lower 95%-LOA of -2.6 (95%-CI -3.1 to -2.0) L/min and an upper 95%-LOA of 2.3 (95%-CI 1.6 to 2.9) L/min. The percentage error was 47% (95%-CI, 37 to 56%). The concordance rate for cardiac output changes was 48%. In this study, the agreement between EC-CO and PATD-CO was not clinically acceptable in patients after CABG surgery. The trending ability of EC-CO was poor.
心输出量可通过使用ICON®监护仪（德国柏林Osypka Medical GmbH公司）的电阻抗心动描记法进行无创估计。关于电阻抗心动描记法的心输出量测量性能，已有相互矛盾的结果报道。在这项前瞻性方法比较研究中，我们比较了冠状动脉旁路移植术（CABG）后患者使用电阻抗心动描记法测量的心输出量（EC-CO；测试方法）与使用间歇性肺动脉热稀释法测量的心输出量（PATD-CO；参考方法）。我们使用Bland-Altman分析计算差异均值及95%一致性界限（95%-LOA）及其相应的95%置信区间（95%-CI），并计算百分比误差。我们还使用四象限图分析进行趋势分析。我们分析了41例患者的157对心输出量测量值。PATD-CO的均值±标准差为5.1±1.3L/分钟，EC-CO的均值为5.3±1.3L/分钟。PATD-CO与EC-CO之间差异的均值±标准差为-0.2（95%-CI -0.5至0.2）±1.2L/分钟，95%较低一致性界限为-2.6（95%-CI -3.1至-2.0）L/分钟，95%较高一致性界限为2.3（95%-CI 1.6至2.9）L/分钟。百分比误差为47%（95%-CI，37至56%）。心输出量变化的一致率为48%。在本研究中，CABG术后患者中EC-CO与PATD-CO之间的一致性在临床上不可接受。EC-CO的趋势分析能力较差。
