Premium
Clinical evaluation of a new tracheal impedance cardiography method
Author(s) -
van der Kleij S. C. J.,
Koolen B. B.,
Newhall D. A.,
Gerritse B. M.,
Rosseel P. M. J.,
Rijpstra T. A.,
Geisler F. E. A.,
van der Meer N. J. M.
Publication year - 2012
Publication title -
anaesthesia
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.839
H-Index - 117
eISSN - 1365-2044
pISSN - 0003-2409
DOI - 10.1111/j.1365-2044.2012.07089.x
Subject(s) - medicine , impedance cardiography , cardiac output , limits of agreement , pulmonary artery , cardiac surgery , anesthesia , cardiology , hemodynamics , stroke volume , nuclear medicine , heart rate , blood pressure
Summary Non‐invasive cardiac output measurement by means of impedance cardiography has been evaluated before, and agreement with other methods has been variable. We decided to study a newly developed tracheal impedance device, that is claimed to be more accurate and reliable. This incorporates new software and mathematical formulae, that are designed to reduce signal noise from diathermy, leading to improved accuracy. In 25 cardiothoracic surgery patients, simultaneous measurements were performed using both pulmonary artery thermodilution and the tracheal impedance device, at five peri‐operative time points: before skin incision; after weaning from cardiopulmonary bypass; after sternal closure; and 30 min and 2 h after arrival in the intensive care unit. Mean cardiac output, bias and 95% limits of agreement were 5.3, 0.03 and −2.8 to 2.8 l.min −1 , respectively. Tracheal impedance showed good correlation with measurement trends using thermodilution in 88% of measurements, with a mean (95% limit of agreement) angular bias of −9.0° (−83.3 to 65.3°). However, the wide limits of agreement and high percentage error of 53% that were apparent in this study mean that, in its present guise, tracheal impedance is not an acceptable alternative to thermodilution in cardiac surgical patients.