An autocalibrating algorithm for non-invasive cardiac output determination based on the analysis of an arterial pressure waveform recorded with radial artery applanation tonometry: A proof of concept pilot analysis

TY - JOUR

T1 - An autocalibrating algorithm for non-invasive cardiac output determination based on the analysis of an arterial pressure waveform recorded with radial artery applanation tonometry: A proof of concept pilot analysis

AU - Saugel, Bernd

AU - Meidert, Agnes S

AU - Langwieser, Nicolas

AU - Wagner, Julia

AU - Fassio, Florian

AU - Hapfelmeier, Alexander

AU - Prechtl, Luisa M

AU - Huber, Wolfgang

AU - Schmid, Roland M

AU - Gödje, Oliver

N1 - Wagner für: III. Medizinische Klinik, Klinikum rechts der Isar der Technischen Universita¨t Mu¨nchen, Ismaninger Strasse 22, 81675 Munich, Germany Saugel für: II, Medizinische Klinik und Poliklinik, Klinikum rechts der Isar der Technischen Universität München, Ismaninger Strasse 22, 81675 München, Germany. bernd.saugel@gmx.de

PY - 2014/8/28

Y1 - 2014/8/28

N2 - We aimed to describe and evaluate an autocalibrating algorithm for determination of cardiac output (CO) based on the analysis of an arterial pressure (AP) waveform recorded using radial artery applanation tonometry (AT) in a continuous non-invasive manner. To exemplarily describe and evaluate the CO algorithm, we deliberately selected 22 intensive care unit patients with impeccable AP waveforms from a database including AP data obtained with AT (T-Line system; Tensys Medical Inc.). When recording AP data for this prospectively maintained database, we had simultaneously noted CO measurements obtained from just calibrated pulse contour analysis (PiCCO system; Pulsion Medical Systems) every minute. We applied the autocalibrating CO algorithm to the AT-derived AP waveforms and noted the computed CO values every minute during a total of 15 min of data recording per patient (3 × 5-min intervals). These 330 AT-derived CO (AT-CO) values were then statistically compared to the corresponding pulse contour CO (PC-CO) values. Mean ± standard deviation for PC-CO and AT-CO was 7.0 ± 2.0 and 6.9 ± 2.1 L/min, respectively. The coefficient of variation for PC-CO and AT-CO was 0.280 and 0.299, respectively. Bland-Altman analysis demonstrated a bias of +0.1 L/min (standard deviation 0.8 L/min; 95 % limits of agreement -1.5 to 1.7 L/min, percentage error 23 %). CO can be computed based on the analysis of the AP waveform recorded with AT. In the selected patients included in this pilot analysis, a percentage error of 23 % indicates clinically acceptable agreement between AT-CO and PC-CO.

AB - We aimed to describe and evaluate an autocalibrating algorithm for determination of cardiac output (CO) based on the analysis of an arterial pressure (AP) waveform recorded using radial artery applanation tonometry (AT) in a continuous non-invasive manner. To exemplarily describe and evaluate the CO algorithm, we deliberately selected 22 intensive care unit patients with impeccable AP waveforms from a database including AP data obtained with AT (T-Line system; Tensys Medical Inc.). When recording AP data for this prospectively maintained database, we had simultaneously noted CO measurements obtained from just calibrated pulse contour analysis (PiCCO system; Pulsion Medical Systems) every minute. We applied the autocalibrating CO algorithm to the AT-derived AP waveforms and noted the computed CO values every minute during a total of 15 min of data recording per patient (3 × 5-min intervals). These 330 AT-derived CO (AT-CO) values were then statistically compared to the corresponding pulse contour CO (PC-CO) values. Mean ± standard deviation for PC-CO and AT-CO was 7.0 ± 2.0 and 6.9 ± 2.1 L/min, respectively. The coefficient of variation for PC-CO and AT-CO was 0.280 and 0.299, respectively. Bland-Altman analysis demonstrated a bias of +0.1 L/min (standard deviation 0.8 L/min; 95 % limits of agreement -1.5 to 1.7 L/min, percentage error 23 %). CO can be computed based on the analysis of the AP waveform recorded with AT. In the selected patients included in this pilot analysis, a percentage error of 23 % indicates clinically acceptable agreement between AT-CO and PC-CO.

U2 - 10.1007/s10877-013-9540-8

DO - 10.1007/s10877-013-9540-8

M3 - SCORING: Journal article

C2 - 24322474

VL - 28

SP - 357

EP - 362

JO - J CLIN MONIT COMPUT

JF - J CLIN MONIT COMPUT

SN - 1387-1307

IS - 4

ER -