Agreement of cardiac output measurement between pulse contour analysis and thermodilution in various body positions: A porcine study

Ping Cheng Shih, Yu Chun Hung, Ying Lun Chen, Hsin Jung Tsai, Chia Ying Chen, Chun Jen Huang

Research output: Contribution to journalArticle

2 Citations (Scopus)

Abstract

Background: We elucidated the effects of various body positions on the agreement of cardiac output (CO) measurement between pulse contour analysis with the PiCCO monitor and thermodilution with pulmonary artery catheterization. Methods: Fifteen anesthetized and mechanically ventilated pigs (40 ± 2 kg) were sequentially placed in various positions to facilitate simultaneous CO measurement. Between-methods agreement was assessed using the Bland-Altman method. Trending ability was assessed using Pearson product-moment correlation coefficient analysis. Results: In supine, reverse Trendelenburg, Trendelenburg, and left lateral decubitus (lateral) positions, CO measured by these two methods was comparable (4.9 ± 1.5 versus 4.6 ± 1.6 L/min, 4.6 ± 2.2 versus 4.8 ± 1.8 L/min, 5.1 ± 2.1 versus 4.9 ± 2.1 L/min, and 5.4 ± 1.8 versus 5.0 ± 1.6 L/min; all P > 0.05). Mean bias between methods and limits of agreement (percentage error) were 0.3 ± 2.9 L/min (61%), -0.3 ± 3.3 L/min (71%), 0.1 ± 4.1 L/min (77%), and 0.5 ± 3.7 L/min (71%). Directional changes of paired CO revealed 66% (reverse Trendelenburg), 57% (Trendelenburg), and 66% (lateral) concordance. The correlation coefficient (r2) was 0.199, 0.127, and 0.108. For paired CO ≤6 L/min, mean bias between methods and limits of agreement (percentage error) were 0.2 ± 1.0 L/min (25%), -0.1 ± 1.0 L/min (28%), 0.2 ± 1.1 L/min (29%), and 0.5 ± 0.9 L/min (23%). Directional changes of paired CO revealed 84% (reverse Trendelenburg), 76% (Trendelenburg), and 65% (lateral) concordance. The correlation coefficient (r2) was 0.583, 0.626, and 0.213. Conclusions: The mean CO measured by pulse contour analysis and thermodilution did not agree well in various body positions. Moreover, the measurements tended to trend differently in response to positional changes. For paired CO ≤6 L/min, however, the between-methods agreement and the trending ability improved significantly.

Original languageEnglish
Pages (from-to)315-322
Number of pages8
JournalJournal of Surgical Research
Volume181
Issue number2
DOIs
Publication statusPublished - May 15 2013
Externally publishedYes

Fingerprint

Thermodilution
Cardiac Output
Pulse
Swine
Swan-Ganz Catheterization

Keywords

  • Bland-Altman
  • Lateral decubitus
  • Pulse contour analysis
  • Reverse Trendelenburg
  • Supine
  • Thermodilution
  • Trendelenburg

ASJC Scopus subject areas

  • Surgery

Cite this

Agreement of cardiac output measurement between pulse contour analysis and thermodilution in various body positions : A porcine study. / Shih, Ping Cheng; Hung, Yu Chun; Chen, Ying Lun; Tsai, Hsin Jung; Chen, Chia Ying; Huang, Chun Jen.

In: Journal of Surgical Research, Vol. 181, No. 2, 15.05.2013, p. 315-322.

Research output: Contribution to journalArticle

Shih, Ping Cheng ; Hung, Yu Chun ; Chen, Ying Lun ; Tsai, Hsin Jung ; Chen, Chia Ying ; Huang, Chun Jen. / Agreement of cardiac output measurement between pulse contour analysis and thermodilution in various body positions : A porcine study. In: Journal of Surgical Research. 2013 ; Vol. 181, No. 2. pp. 315-322.
@article{34d7ed4108c644c69be49c4b0a118764,
title = "Agreement of cardiac output measurement between pulse contour analysis and thermodilution in various body positions: A porcine study",
abstract = "Background: We elucidated the effects of various body positions on the agreement of cardiac output (CO) measurement between pulse contour analysis with the PiCCO monitor and thermodilution with pulmonary artery catheterization. Methods: Fifteen anesthetized and mechanically ventilated pigs (40 ± 2 kg) were sequentially placed in various positions to facilitate simultaneous CO measurement. Between-methods agreement was assessed using the Bland-Altman method. Trending ability was assessed using Pearson product-moment correlation coefficient analysis. Results: In supine, reverse Trendelenburg, Trendelenburg, and left lateral decubitus (lateral) positions, CO measured by these two methods was comparable (4.9 ± 1.5 versus 4.6 ± 1.6 L/min, 4.6 ± 2.2 versus 4.8 ± 1.8 L/min, 5.1 ± 2.1 versus 4.9 ± 2.1 L/min, and 5.4 ± 1.8 versus 5.0 ± 1.6 L/min; all P > 0.05). Mean bias between methods and limits of agreement (percentage error) were 0.3 ± 2.9 L/min (61{\%}), -0.3 ± 3.3 L/min (71{\%}), 0.1 ± 4.1 L/min (77{\%}), and 0.5 ± 3.7 L/min (71{\%}). Directional changes of paired CO revealed 66{\%} (reverse Trendelenburg), 57{\%} (Trendelenburg), and 66{\%} (lateral) concordance. The correlation coefficient (r2) was 0.199, 0.127, and 0.108. For paired CO ≤6 L/min, mean bias between methods and limits of agreement (percentage error) were 0.2 ± 1.0 L/min (25{\%}), -0.1 ± 1.0 L/min (28{\%}), 0.2 ± 1.1 L/min (29{\%}), and 0.5 ± 0.9 L/min (23{\%}). Directional changes of paired CO revealed 84{\%} (reverse Trendelenburg), 76{\%} (Trendelenburg), and 65{\%} (lateral) concordance. The correlation coefficient (r2) was 0.583, 0.626, and 0.213. Conclusions: The mean CO measured by pulse contour analysis and thermodilution did not agree well in various body positions. Moreover, the measurements tended to trend differently in response to positional changes. For paired CO ≤6 L/min, however, the between-methods agreement and the trending ability improved significantly.",
keywords = "Bland-Altman, Lateral decubitus, Pulse contour analysis, Reverse Trendelenburg, Supine, Thermodilution, Trendelenburg",
author = "Shih, {Ping Cheng} and Hung, {Yu Chun} and Chen, {Ying Lun} and Tsai, {Hsin Jung} and Chen, {Chia Ying} and Huang, {Chun Jen}",
year = "2013",
month = "5",
day = "15",
doi = "10.1016/j.jss.2012.07.012",
language = "English",
volume = "181",
pages = "315--322",
journal = "Journal of Surgical Research",
issn = "0022-4804",
publisher = "Academic Press Inc.",
number = "2",

}

TY - JOUR

T1 - Agreement of cardiac output measurement between pulse contour analysis and thermodilution in various body positions

T2 - A porcine study

AU - Shih, Ping Cheng

AU - Hung, Yu Chun

AU - Chen, Ying Lun

AU - Tsai, Hsin Jung

AU - Chen, Chia Ying

AU - Huang, Chun Jen

PY - 2013/5/15

Y1 - 2013/5/15

N2 - Background: We elucidated the effects of various body positions on the agreement of cardiac output (CO) measurement between pulse contour analysis with the PiCCO monitor and thermodilution with pulmonary artery catheterization. Methods: Fifteen anesthetized and mechanically ventilated pigs (40 ± 2 kg) were sequentially placed in various positions to facilitate simultaneous CO measurement. Between-methods agreement was assessed using the Bland-Altman method. Trending ability was assessed using Pearson product-moment correlation coefficient analysis. Results: In supine, reverse Trendelenburg, Trendelenburg, and left lateral decubitus (lateral) positions, CO measured by these two methods was comparable (4.9 ± 1.5 versus 4.6 ± 1.6 L/min, 4.6 ± 2.2 versus 4.8 ± 1.8 L/min, 5.1 ± 2.1 versus 4.9 ± 2.1 L/min, and 5.4 ± 1.8 versus 5.0 ± 1.6 L/min; all P > 0.05). Mean bias between methods and limits of agreement (percentage error) were 0.3 ± 2.9 L/min (61%), -0.3 ± 3.3 L/min (71%), 0.1 ± 4.1 L/min (77%), and 0.5 ± 3.7 L/min (71%). Directional changes of paired CO revealed 66% (reverse Trendelenburg), 57% (Trendelenburg), and 66% (lateral) concordance. The correlation coefficient (r2) was 0.199, 0.127, and 0.108. For paired CO ≤6 L/min, mean bias between methods and limits of agreement (percentage error) were 0.2 ± 1.0 L/min (25%), -0.1 ± 1.0 L/min (28%), 0.2 ± 1.1 L/min (29%), and 0.5 ± 0.9 L/min (23%). Directional changes of paired CO revealed 84% (reverse Trendelenburg), 76% (Trendelenburg), and 65% (lateral) concordance. The correlation coefficient (r2) was 0.583, 0.626, and 0.213. Conclusions: The mean CO measured by pulse contour analysis and thermodilution did not agree well in various body positions. Moreover, the measurements tended to trend differently in response to positional changes. For paired CO ≤6 L/min, however, the between-methods agreement and the trending ability improved significantly.

AB - Background: We elucidated the effects of various body positions on the agreement of cardiac output (CO) measurement between pulse contour analysis with the PiCCO monitor and thermodilution with pulmonary artery catheterization. Methods: Fifteen anesthetized and mechanically ventilated pigs (40 ± 2 kg) were sequentially placed in various positions to facilitate simultaneous CO measurement. Between-methods agreement was assessed using the Bland-Altman method. Trending ability was assessed using Pearson product-moment correlation coefficient analysis. Results: In supine, reverse Trendelenburg, Trendelenburg, and left lateral decubitus (lateral) positions, CO measured by these two methods was comparable (4.9 ± 1.5 versus 4.6 ± 1.6 L/min, 4.6 ± 2.2 versus 4.8 ± 1.8 L/min, 5.1 ± 2.1 versus 4.9 ± 2.1 L/min, and 5.4 ± 1.8 versus 5.0 ± 1.6 L/min; all P > 0.05). Mean bias between methods and limits of agreement (percentage error) were 0.3 ± 2.9 L/min (61%), -0.3 ± 3.3 L/min (71%), 0.1 ± 4.1 L/min (77%), and 0.5 ± 3.7 L/min (71%). Directional changes of paired CO revealed 66% (reverse Trendelenburg), 57% (Trendelenburg), and 66% (lateral) concordance. The correlation coefficient (r2) was 0.199, 0.127, and 0.108. For paired CO ≤6 L/min, mean bias between methods and limits of agreement (percentage error) were 0.2 ± 1.0 L/min (25%), -0.1 ± 1.0 L/min (28%), 0.2 ± 1.1 L/min (29%), and 0.5 ± 0.9 L/min (23%). Directional changes of paired CO revealed 84% (reverse Trendelenburg), 76% (Trendelenburg), and 65% (lateral) concordance. The correlation coefficient (r2) was 0.583, 0.626, and 0.213. Conclusions: The mean CO measured by pulse contour analysis and thermodilution did not agree well in various body positions. Moreover, the measurements tended to trend differently in response to positional changes. For paired CO ≤6 L/min, however, the between-methods agreement and the trending ability improved significantly.

KW - Bland-Altman

KW - Lateral decubitus

KW - Pulse contour analysis

KW - Reverse Trendelenburg

KW - Supine

KW - Thermodilution

KW - Trendelenburg

UR - http://www.scopus.com/inward/record.url?scp=84876410369&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=84876410369&partnerID=8YFLogxK

U2 - 10.1016/j.jss.2012.07.012

DO - 10.1016/j.jss.2012.07.012

M3 - Article

C2 - 22884452

AN - SCOPUS:84876410369

VL - 181

SP - 315

EP - 322

JO - Journal of Surgical Research

JF - Journal of Surgical Research

SN - 0022-4804

IS - 2

ER -