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The impact of systemic vascular resistance on the accuracy of the FloTrac/Vigileo™ system in the perioperative period of cardiac surgery: a prospective observational comparison study

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Abstract

FloTrac/Vigileo™ system is based on arterial pressure waveform analysis arterial pressure-based CO (APCO). Therefore, systemic vascular resistance (SVR) can influence the accuracy of APCO. The purpose of this study is to evaluate the relationship between SVR and the accuracy of APCO. We managed 50 consecutive patients in the perioperative period of cardiac surgery with FloTrac/Vigileo™ system (v. 3.02) and Swan–Ganz catheter/Vigilance™ system pulmonary artery catheter-based CO (PAC-CO) simultaneously. Continuous hemodynamic measurement using both methods was performed every 20 s from the induction of anesthesia to PAC removal 4 h after extubation. A total of 11,092 (intraoperative), 38,455 (postoperative, pre-extubation), and 44,235 (postoperative, post-extubation) data pairs were finally analyzed. Bland–Altman analysis revealed that in the intraoperative [postoperative pre-extubation, post-extubation] period, the bias was 0.5 [0.1, 0.0] L/min and the limits of agreement ranged from −2.4 to 3.3 [−2.2 to 2.4, −2.4 to 2.3] L/min. The percentage error was 60.3 [54.5, 48.5] %. Regression analysis of the systemic vascular resistance index (SVRI) and the bias between APCO and PAC-CO showed that the bias was positively correlated to the SVRI. Subanalysis based on SVR with Lin’s concordance correlation coefficient revealed that relatively satisfactory concordance was found in the normal-SVR group (concordance correlation coefficient ρ c = 0.51–0.56) regardless of vasoactive agent use. The accuracy of the FloTrac/Vigileo™ System (v. 3.02) is relatively satisfactory in the condition with normal SVR regardless of vasoactive agent use. Positive correlation between the bias and SVR can be the clue to the more effective use of FloTrac/Vigileo™ system.

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Acknowledgments

We acknowledge the nursing staff, clinical engineers, office administrators of Sakurabashi-Watanabe hospital for their kind support in performing this study.

Conflict of interest

The authors declare that they have no conflict of interest.

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Authors and Affiliations

  1. Cardiovascular Center, Sakurabashi-Watanabe Hospital, 2-4-32 Umeda, Kita-ku, Osaka, 530-0001, Japan

    Yohei Sotomi, Katsuomi Iwakura, Yoshiharu Higuchi & Kenshi Fujii

  2. Department of Anesthesiology, Sakurabashi-Watanabe Hospital, Osaka, Japan

    Kazuo Abe & Junko Yoshida

  3. Department of Cardiovascular Surgery, Sakurabashi-Watanabe Hospital, Osaka, Japan

    Takafumi Masai

Authors
  1. Yohei Sotomi
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  2. Katsuomi Iwakura
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  3. Yoshiharu Higuchi
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  4. Kazuo Abe
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  5. Junko Yoshida
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  6. Takafumi Masai
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  7. Kenshi Fujii
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Correspondence to Yohei Sotomi.

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Sotomi, Y., Iwakura, K., Higuchi, Y. et al. The impact of systemic vascular resistance on the accuracy of the FloTrac/Vigileo™ system in the perioperative period of cardiac surgery: a prospective observational comparison study. J Clin Monit Comput 27, 639–646 (2013). https://doi.org/10.1007/s10877-013-9481-2

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  • DOI: https://doi.org/10.1007/s10877-013-9481-2

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