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Anesth Analg 2009; 109:114-118
© 2009 International Anesthesia Research Society
doi: 10.1213/ane.0b013e3181a491b8
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TECHNOLOGY, COMPUTING, AND SIMULATION

Pulse Contour Analysis and Transesophageal Echocardiography: A Comparison of Measurements of Cardiac Output During Laparoscopic Colon Surgery

Mario R. Concha, MD, Verónica F. Mertz, MD, Luis I. Cortínez, MD, Katya A. González, MD, and Jean M. Butte, MD

From the Departments of Anesthesiology and Digestive Surgery, Escuela de Medicina, Pontificia Universidad Católica de Chile, Santiago, Chile.

Address correspondence and reprint requests to Mario Concha, MD, Departamento de Anestesiología, Hospital Clínico Universidad Católica de Chile, Santiago, Chile. Address e-mail to mconcha{at}med.puc.cl.

BACKGROUND: Pulse wave analysis (PWA) allows cardiac output (CO) measurement after calibration by transpulmonary thermodilution. A PWA system that does not require previous calibration, the FloTrac/Vigileo (FTV), has been recently developed. We compared determinations of CO made with the FTV to simultaneous measurements using transesophageal echocardiography (TEE).

METHOD: Ten ASA I-II patients scheduled for laparoscopic colorectal surgery were studied. A radial 20-gauge cannula was inserted and connected to a hemodynamic monitor and a FTV system for PWA and determination of CO (COPWA). TEE CO (COTEE) was determined as previously described. Measurements were made after intubation, 5 min after establishing the lithotomy position, 5 min after establishing pneumoperitoneum, every 30 min, or each time mean arterial blood pressure decreased below basal values. Statistical analysis was made with the Bland and Altman method.

RESULTS: Eighty-eight measurements were compared. The COTEE values ranged from 3.23 to 12 Lt/min (mean 6.21 ± 1.85). Values for COPWA ranged from 2.9 to 8.5 Lt/min (mean 4.84 ± 1.14). Bias was 1.17 and limits of agreement –2.02 and 4.37. The percentage error between all COTEE and COPWA measurements was 40% (27%-50%) mean (range).

CONCLUSION: During laparoscopic colon surgery, clinically important differences were observed between CO determinations made with TEE and FTV.






Lippincott, Williams & Wilkins Anesthesia & Analgesia® is published for the International Anesthesia Research Society® by Lippincott Williams & Wilkins and Stanford University Libraries' HighWire Press®. Copyright 2009 by the International Anesthesia Research Society. Online ISSN: 1526-7598   Print ISSN: 0003-2999 HighWire Press
Copyright © 2009 by the International Anesthesia Research Society.