dc.contributor.author
Reshetnik, Alexander
dc.contributor.author
Gjolli, Jonida
dc.contributor.author
Giet, Markus van der
dc.contributor.author
Compton, Friederike
dc.date.accessioned
2021-11-04T09:22:33Z
dc.date.available
2021-11-04T09:22:33Z
dc.identifier.uri
https://refubium.fu-berlin.de/handle/fub188/32522
dc.identifier.uri
http://dx.doi.org/10.17169/refubium-32246
dc.description.abstract
While invasive thermodilution techniques remain the reference methods for cardiac output (CO) measurement, there is a currently unmet need for non-invasive techniques to simplify CO determination, reduce complications related to invasive procedures required for indicator dilution CO measurement, and expand the application field toward emergency room, non-intensive care, or outpatient settings. We evaluated the performance of a non-invasive oscillometry-based CO estimation method compared to transpulmonary thermodilution. To assess agreement between the devices, we used Bland-Altman analysis. Four-quadrant plot analysis was used to visualize the ability of Mobil-O-Graph (MG) to track CO changes after a fluid challenge. Trending analysis of CO trajectories was used to compare MG and PiCCO® calibrated pulse wave analysis over time (6 h). We included 40 patients from the medical intensive care unit at the Charite - Universitatsmedizin Berlin, Campus Benjamin Franklin between November 2019 and June 2020. The median age was 73 years. Forty percent of the study population was male; 98% was ventilator-dependent and 75% vasopressor-dependent at study entry. The mean of the observed differences for the cardiac output index (COI) was 0.7 l*min(-1*)m(-2) and the lower, and upper 95% limits of agreement (LOA) were -1.9 and 3.3 l*min(-1*)m(-2), respectively. The 95% confidence interval for the LOA was ± 0.26 l*min(-1*)m(-2), the percentage error 83.6%. We observed concordant changes in CO with MG and PiCCO® in 50% of the measurements after a fluid challenge and over the course of 6 h. Cardiac output calculation with a novel oscillometry-based pulse wave analysis method is feasible and replicable in critically ill patients. However, we did not find clinically applicable agreement between MG and thermodilution or calibrated pulse wave analysis, respectively, assessed with established evaluation routine using the Bland-Altman approach and with trending analysis methods. In summary, we do not recommend the use of this method in critically ill patients at this time. As the basic approach is promising and the CO determination with MG very simple to perform, further studies should be undertaken both in hemodynamically stable patients, and in the critical care setting to allow additional adjustments of the underlying algorithm for CO estimation with MG.
en
dc.rights.uri
https://creativecommons.org/licenses/by/4.0/
dc.subject
non-invasive
en
dc.subject
cardiac output measurement
en
dc.subject
thermodilution
en
dc.subject
oscillometric
en
dc.subject
pulse wave analysis
en
dc.subject.ddc
600 Technik, Medizin, angewandte Wissenschaften::610 Medizin und Gesundheit::610 Medizin und Gesundheit
dc.title
Non-invasive Oscillometry-Based Estimation of Cardiac Output – Can We Use It in Clinical Practice?
dc.type
Wissenschaftlicher Artikel
dcterms.bibliographicCitation.articlenumber
704425
dcterms.bibliographicCitation.doi
10.3389/fphys.2021.704425
dcterms.bibliographicCitation.journaltitle
Frontiers in Physiology
dcterms.bibliographicCitation.originalpublishername
Frontiers Media SA
dcterms.bibliographicCitation.volume
12
refubium.affiliation
Charité - Universitätsmedizin Berlin
refubium.resourceType.isindependentpub
no
dcterms.accessRights.openaire
open access
dcterms.bibliographicCitation.pmid
34413788
dcterms.isPartOf.eissn
1664-042X