Research
Comparison between Flotrac-Vigileo and Bioreactance, a totally noninvasive method for cardiac output monitoring
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* Corresponding author: Pierre Squara pierre.squara@wanadoo.fr
1 Medical Intensive Care Unit, Cochin Hospital, 27 rue du Faubourg Saint-Jacques 75679 Paris Cedex 14, France
2 Paris Descartes University, Medical School, 15 rue de l'Ecole de Médecine 75270 Paris Cedex 06, France
3 Clinique Ambroise Paré, 27 bd Victor Hugo, 92200 Neuilly-sur-Seine, France
Critical Care 2009, 13:R73 doi:10.1186/cc7884
Published: 19 May 2009Abstract
Introduction
This study was designed to compare the clinical acceptability of two cardiac output (CO) monitoring systems: a pulse wave contour-based system (FloTrac-Vigileo) and a bioreactance-based system (NICOM), using continuous thermodilution (PAC-CCO) as a reference method.
Methods
Consecutive patients, requiring PAC-CCO monitoring following cardiac surgery, were also monitored by the two other devices. CO values obtained simultaneously by the three systems were recorded continuously on a minute-by-minute basis.
Results
Continuous recording was performed on 29 patients, providing 12,099 simultaneous measurements for each device (417 ± 107 per patient). In stable conditions, correlations of NICOM and Vigileo with PAC-CCO were 0.77 and 0.69, respectively. The bias was -0.01 ± 0.84 for NICOM and -0.01 ± 0.81 for Vigileo (NS). NICOM relative error was less than 30% in 94% of the patients and less than 20% in 79% vs. 91% and 79% for the Vigileo, respectively (NS). The variability of measurements around the trend line (precision) was not different between the three methods: 8 ± 3%, 8 ± 4% and 8 ± 3% for PAC-CCO, NICOM and Vigileo, respectively. CO changes were 7.2 minutes faster with Vigileo and 6.9 minutes faster with NICOM (P < 0.05 both systems vs. PAC-CCO, NS). Amplitude of changes was not significantly different than thermodilution. Finally, the sensitivity and specificity for predicting significant CO changes were 0.91 and 0.95 respectively for the NICOM and 0.86 and 0.92 respectively for the Vigileo.
Conclusions
This study showed that the NICOM and Vigileo devices have similar monitoring capabilities in post-operative cardiac surgery patients.