Abstract
Purpose
A new semi-continuous thermodilution cardiac output (CCO) system has been developed recently (Opti-Q™ and Q-vue™ Abbott critical care system). The aim of this study was to compare the accuracy and reproducibility of this new device with conventional ice-bolus thermodilution cardiac output (BCO).
Methods
Fifteen critically ill patients who needed pulmonary artery catheterization were prospectively investigated. Eighty seven paired data using BCO and CCO methods were compared. Reproducibility was assessed from 90 BCO and 87 CCO determinations by calculation of the mean standard error (SEM) and according to Bland and Altman methodology.
Results
The BCO and CCO ranged from 2.46 to 11.20 L·min−1 and from 1.75 to 10.05 L·min−1 respectively. Bias (mean difference between BCO and CCO) was null (0.002 L·min−1,P = 0.98), precision (SD of the bias) was 0.74 L·min−1 and the limits of agreement (mean difference ± 1.96 SD) ranged from -1.45 to 1.45 L·min−1. The threshold to consider two cardiac outputs as different (3 × SEM) was equivalent for BCO and CCO (0.54 and 0.465 L·min−1 respectively). According to the Bland and Altman method, reproducibility of CCO was greater than that of BCO: bias of repeated measurements of BCO and CCO were 0.15 L·min−1 (P < 0.05) and 0.047 L·min−1 (NS), respectively.
Conclusion
Compared with BCO, this new device was accurate but cannot be considered as interchangeable regarding the limits of agreement. Reproducibility of CCO was superior to BCO.
Résumé
Objectifs
Récemment, un nouveau système de mesure semi-continue du débit cardiaque (CCO) a été commercialisé (Opti-™ and Q-vue Abbott critical care system). Le but de cette étude était d’évaluer les performances de ce nouveau système en comparaison à la thermodilution classique par injection de soluté froid (BCO).
Méthodes
Quinze patients de réanimation, pour lesquels l’indication d’un cathétérisme droit était posée, ont été prospectivement évalués. Quatre vingt sept couples de mesures étaient comparés. La reproductibilité était estimée par le calcul de l’erreur standard moyenne (SEM) et selon la méthode de Bland et Altman sur 90 mesures pour le BCO et 87 pour le CCQ.
Résultats
Les BCO et CCO s’étendaient respectivement de 2,46 à 11,20 L·min−1 et 1,75 à 10,05 L·min−1. Le biais (différence moyenne entre BCO et CCO) était nul (0,002 L·min−1,P = 0,98), la précision (écart type du biais) était de 0,74 L·min−1 et les limites d’agrément (biais ± 1,96 écart type) s’étendaient de -1,45 à 1,45 L·min−1. Le seuil pour considérer deux débits cardiaques comme différents (3 × SEM) pour BCO et CCO était équivalent (0,54 et 0,465 L·min−1 respectivement). Néanmoins selon la méthode de Bland et Altman, la reproductibilité du CCO était supérieure à celle du BCO: le biais de mesures répétées pour BCO et CCO était respectivement de 0,15 L·min−1 (P < 0,05) et 0,047 L·min−1 (NS).
Conclusions
Comparé à la thermodilution classique ce nouveau système de mesure en continu du débit cardiaque est suffisant en pratique clinique mais ne peut être réellement considérer comme interchangeable. La reproductibilité du CCO est supérieure au BCO.
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Seguin, P., Colcanap, O., Le Rouzo, A. et al. Evaluation of a new semi-continuous cardiac output system in the intensive care unit. Can J Anaesth 45, 578–583 (1998). https://doi.org/10.1007/BF03012713
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DOI: https://doi.org/10.1007/BF03012713