Continuous Cardiac Output Measurement during Off-Pump Coronary Artery Bypass Grafting: Radial Arterial Pulse Wave versus Femoral Arterial Pulse Wave
Subject Editor: Supported by: None
07 March 2018 (online)
Background and Objectives Measurement of cardiac output (CO) during off-pump coronary artery bypass grafting (OP-CABG) is useful to assess the impact of displacement of heart during surgery. FloTrac uses the pulse-contour analysis algorithm to derive stroke volume (SV) and CO. This study was aimed to determine whether the site of monitoring of arterial pressure influences the CO measurement using Flotrac/Vigileo.
Methods The authors recorded 75 sets of observations in 15 patients who underwent elective OP-CABG. Each patient had the radial and femoral artery cannulated and connected to FloTrac/Vigileo. The hemodynamic parameters were monitored at specified points of time intraoperatively.
Results The CO, cardiac index, SV, stroke volume index, and stroke volume variation measured from radial artery did not differ from those of femoral artery at all points of measurement.
Conclusion Either of the sites of monitoring of arterial pressure (namely radial and femoral artery) is acceptable for monitoring CO during OP-CABG.
- 1 Dr Gerry Manecke. Poster, SCCM 2005. Dr William McGee, Poster, ISICEM; 2005
- 2 Manecke Jr GR, Auger WR. Cardiac output determination from the arterial pressure wave: clinical testing of a novel algorithm that does not require calibration. J Cardiothorac Vasc Anesth 2007; 21 (01) 3-7
- 3 Mehta Y, Chand RK, Sawhney R, Bhise M, Singh A, Trehan N. Cardiac output monitoring: comparison of a new arterial pressure waveform analysis to the bolus thermodilution technique in patients undergoing off-pump coronary artery bypass surgery. J Cardiothorac Vasc Anesth 2008; 22 (03) 394-399
- 4 Breukers RM, Sepehrkhouy S, Spiegelenberg SR, Groeneveld AB. Cardiac output measured by a new arterial pressure waveform analysis method without calibration compared with thermodilution after cardiac surgery. J Cardiothorac Vasc Anesth 2007; 21 (05) 632-635
- 5 Reich DL, Mittnacht A, London M, Kaplan J. Monitoring of the heart and vascular system. In: Kaplan JA, Reich DL, Lake CL, Konstadt SN, eds. Kaplan’s Cardiac Anaesthesia. Philadelphia, PA: Elsevier Saunders; 2006:386
- 6 Gödje O, Höke K, Goetz AE. et al. Reliability of a new algorithm for continuous cardiac output determination by pulse-contour analysis during hemodynamic instability. Crit Care Med 2002; 30 (01) 52-58
- 7 Pittman J, Bar-Yosef S, SumPing J, Sherwood M, Mark J. Continuous cardiac output monitoring with pulse contour analysis: a comparison with lithium indicator dilution cardiac output measurement. Crit Care Med 2005; 33 (09) 2015-2021
- 8 Chaney JC, Derdak S. Minimally invasive hemodynamic monitoring for the intensivist: current and emerging technology. Crit Care Med 2002; 30 (10) 2338-2345
- 9 Rödig G, Prasser C, Keyl C, Liebold A, Hobbhahn J. Continuous cardiac output measurement: pulse contour analysis vs thermodilution technique in cardiac surgical patients. Br J Anaesth 1999; 82 (04) 525-530
- 10 Yamashita K, Nishiyama T, Yokoyama T, Abe H, Manabe M. Cardiac output by pulse CO is not interchangeable with thermodilution in patients undergoing OPCAB. Can J Anaesth 2005; 52 (05) 530-534
- 11 Pearse RM, Ikram K, Barry J. Equipment review: an appraisal of the LiDCO plus method of measuring cardiac output. Crit Care 2004; 8 (03) 190-195
- 12 de Vaal JB, de Wilde RB, van den Berg PC, Schreuder JJ, Jansen JR. Less invasive determination of cardiac output from the arterial pressure by aortic diameter-calibrated pulse contour. Br J Anaesth 2005; 95 (03) 326-331
- 13 Mayer J, Boldt J, Schöllhorn T, Röhm KD, Mengistu AM, Suttner S. Semi-invasive monitoring of cardiac output by a new device using arterial pressure waveform analysis: a comparison with intermittent pulmonary artery thermodilution in patients undergoing cardiac surgery. Br J Anaesth 2007; 98 (02) 176-182
- 14 Mayer J, Boldt J, Poland R, Peterson A, Manecke Jr GR. Continuous arterial pressure waveform-based cardiac output using the FloTrac/Vigileo: a review and meta-analysis. J Cardiothorac Vasc Anesth 2009; 23 (03) 401-406
- 15 Chatti R, de Rudniki S, Marqué S. et al. Comparison of two versions of the Vigileo-FloTrac system (1.03 and 1.07) for stroke volume estimation: a multicentre, blinded comparison with oesophageal Doppler measurements. Br J Anaesth 2009; 102 (04) 463-469
- 16 Senn A, Button D, Zollinger A, Hofer CK. Assessment of cardiac output changes using a modified FloTrac/Vigileo algorithm in cardiac surgery patients. Crit Care 2009; 13 (02) R32
- 17 Maddali MM, Waje ND, Sathiya PM. Authentication of radial versus femoral arterial pressure waveform-derived cardiac output with transesophageal echocardiography-derived cardiac output measurements in patients undergoing on-pump coronary bypass surgery. J Cardiothorac Vasc Anesth 2017; 31 (04) 1183-1189