Effects of norepinephrine on four different continuous cardiac output systems using the femoral and radial arterial pressure waveform in critically ill patients

TY - JOUR

T1 - Effects of norepinephrine on four different continuous cardiac output systems using the femoral and radial arterial pressure waveform in critically ill patients

AU - Smith, John

AU - Scaramuzzi, Marco

AU - Charlton, Peter

AU - Brooks, John

AU - Arces, Daniele

AU - Wong, Guideon

AU - Camporota, Luigi

AU - Beale, Richard

PY - 2011/9

Y1 - 2011/9

N2 - INTRODUCTION. Pharmacological alterations of the arterial blood pressure waveform (ABPW) can affect arterial pressure-based cardiac output systems (APCOs) independently of stroke volume. However, the morphology of the ABPW can vary between femoral or radial arteries especially in hypovolaemic patients or requiring high-dose vasopressors. We assessed the agreement between the CCO derived from the femoral vs radial artery during a 'double-pump' norepinephrine manoeuvre (NEDP) using four APCOs (PiCCO, LiDCO, PRAM, Vigileo v03.02.pic). METHODS. Comparisons were performed in nine ICU patients before, during and after NEDP. The recorded both radial and femoral ABPW were played back in each APCOs to calculate CCO. RESULTS. Bland-Altmann analysis of the ABPCOs (Femoral-Radial) before, during and after NEDP is shown as [bias (L/min), limits of agreement (LOA)].LiDCO.Before [-0.06 (-0.5 to +0.38]During [0.13 (-0.94 to +0.67)]After [0.25 (-1.1 to +1.6)]PiCCO.Before [-0.03 (-0.53 to +0.47)]During [0.8 (-1.9 to +3.4)]After [0.24 (-1.0 to +1.4)]PRAM.Before [-0.2 (-3.4 to +3.9)]During [0.1 (-3.7 to +3.9)]After [0.5 (-3.8 to +4.8)]Vigileo.Before [ -0.54 (-0.89 to +2.0)]During [0.5 (-2.2 to +3.2)]After [0.4 (-1.9 to +2.8)]CONCLUSIONS. ABPCOs can give potentially large differences in CCO when ABPW is obtained from different arterial sites particularly during rapid changes in vasopressors and in uncalibrated systems.

AB - INTRODUCTION. Pharmacological alterations of the arterial blood pressure waveform (ABPW) can affect arterial pressure-based cardiac output systems (APCOs) independently of stroke volume. However, the morphology of the ABPW can vary between femoral or radial arteries especially in hypovolaemic patients or requiring high-dose vasopressors. We assessed the agreement between the CCO derived from the femoral vs radial artery during a 'double-pump' norepinephrine manoeuvre (NEDP) using four APCOs (PiCCO, LiDCO, PRAM, Vigileo v03.02.pic). METHODS. Comparisons were performed in nine ICU patients before, during and after NEDP. The recorded both radial and femoral ABPW were played back in each APCOs to calculate CCO. RESULTS. Bland-Altmann analysis of the ABPCOs (Femoral-Radial) before, during and after NEDP is shown as [bias (L/min), limits of agreement (LOA)].LiDCO.Before [-0.06 (-0.5 to +0.38]During [0.13 (-0.94 to +0.67)]After [0.25 (-1.1 to +1.6)]PiCCO.Before [-0.03 (-0.53 to +0.47)]During [0.8 (-1.9 to +3.4)]After [0.24 (-1.0 to +1.4)]PRAM.Before [-0.2 (-3.4 to +3.9)]During [0.1 (-3.7 to +3.9)]After [0.5 (-3.8 to +4.8)]Vigileo.Before [ -0.54 (-0.89 to +2.0)]During [0.5 (-2.2 to +3.2)]After [0.4 (-1.9 to +2.8)]CONCLUSIONS. ABPCOs can give potentially large differences in CCO when ABPW is obtained from different arterial sites particularly during rapid changes in vasopressors and in uncalibrated systems.

M3 - Poster abstract

SN - 0342-4642

VL - 37

SP - S241-S241

JO - Intensive Care Medicine

JF - Intensive Care Medicine

IS - S1

M1 - 0943

ER -