首页> 外文期刊>Journal of clinical monitoring and computing >Cardiac output estimation by multi-beat analysis of the radial arterial blood pressure waveform versus intermittent pulmonary artery thermodilution: a method comparison study in patients treated in the intensive care unit after off-pump coronary artery bypass surgery
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Cardiac output estimation by multi-beat analysis of the radial arterial blood pressure waveform versus intermittent pulmonary artery thermodilution: a method comparison study in patients treated in the intensive care unit after off-pump coronary artery bypass surgery

机译:通过多节拍分析对径向动脉血压波形的心输出估计与间歇性肺动脉热渗透:泵浦冠状动脉旁路手术重症监护单元治疗的患者的方法比较研究

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Cardiac output (CO) is a key hemodynamic variable that can be minimally invasively estimated by pulse wave analysis. Multi-beat analysis is a novel pulse wave analysis method. In this prospective observational clinical method comparison study, we compared CO estimations by multi-beat analysis with CO measured by intermittent pulmonary artery thermodilution (PATD) in adult patients treated in the intensive care unit (ICU) after off-pump coronary artery bypass surgery (OPCAB). We included patients after planned admission to the ICU after elective OPCAB who were monitored with a radial arterial catheter and a pulmonary artery catheter. At seven time points, we determined CO using intermittent PATD (PATD-CO; reference method) and simultaneously recorded the radial arterial blood pressure waveform that we later used to estimate CO using multi-beat analysis (MBA-CO; test method) with the Argos monitor (Retia Medical; Valhalla, NY, USA). Blood pressure waveforms impaired by inappropriate damping properties or artifacts were excluded. We compared PATD-CO and MBA-CO using Bland-Altman analysis accounting for repeated measurements, the percentage error, and the concordance rate derived from four-quadrant plot analysis (15% exclusion zone). We analyzed 167 CO values of 31 patients. Mean PATD-CO was 5.30 +/- 1.22 L/min and mean MBA-CO was 5.55 +/- 1.82 L/min. The mean of the differences between PATD-CO and MBA-CO was 0.08 +/- 1.10 L/min (95% limits of agreement: - 2.13 L/min to + 2.29 L/min). The percentage error was 40.7%. The four-quadrant plot-derived concordance rate was 88%. CO estimation by multi-beat analysis of the radial arterial blood pressure waveform (Argos monitor) shows reasonable agreement compared with CO measured by intermittent PATD in adult patients treated in the ICU after OPCAB.
机译:心输出(CO)是通过脉冲波分析最微量血流动力学变量,可以通过脉搏波分析来微创。多节拍分析是一种新型脉冲波分析方法。在这项前瞻性观察临床方法比较研究中,我们通过在泵冠状动脉旁路手术(ICU)的成年患者中,通过间歇性肺动脉热稀释(Patd)测量的Co测定了CO估计。 OPCAB)。我们包括在用桡动脉导管和肺动脉导管监测的选修蛋白酶后对ICU进行预告后的患者。在七个时间点,我们确定了使用间歇式饼(Patd-Co;参考方法)并同时记录了我们以后用于使用多节拍分析(MBA-CO;测试方法)估算CO的径向动脉血压波形。 Argos Monitor(Retia Medical; Valhalla,NY,美国)。排除了不适当的阻尼性能或伪影损害的血压波形。我们将Patd-Co和MBA-CO比较了Bland-Altman分析算法进行重复测量,百分比误差和来自四象限绘图分析(15%排除区)的齐全速率。我们分析了167例患者的167例。平均patd-co为5.30 +/- 1.22 l / min,平均mba-co为5.55 +/- 1.82 l / min。 Patd-Co和MBA-CO之间差异的平均值为0.08 +/- 1.10 L / min(协议限制为95%: - 2.13L / min至+ 2.29 L / min)。百分比误差为40.7%。四象限的情节衍生的一致性率为88%。通过多节拍分析的径向动脉血压波形(Argos Monder)的CO估计显示,与OPCAB中ICU中ICU中的成年患者中的间歇性患者中的间歇性豆章测量的CO合理协议。

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