Table of Content

Open Access

ARTICLE

Inaccuracy of a continuous arterial pressure waveform monitor when used for congenital cardiac catheterization

Michael D. Seckeler1, Katri Typpo2, Jendar Deschenes2, Ruth Higgins3, Ricardo Samson1, Peter Lichtenthal4
1 Department of Pediatrics (Cardiology), University of Arizona, Tucson, Arizona, USA
2 Department of Pediatrics (Critical Care), University of Arizona, Tucson, Arizona, USA
3 Banner University Medical—Tucson, Tucson, Arizona, USA
4 Department of Anesthesiology, University of Arizona, Tucson, Arizona, USA
* Corresponding Author: Michael D. Seckeler, Department of Pediatrics (Cardiology), University of Arizona, 1501 N. Campbell Ave, PO Box 245073, Tucson, AZ85718. Email:

Congenital Heart Disease 2017, 12(6), 815-819. https://doi.org/10.1111/chd.12517

Abstract

Objective: To determine the accuracy of a continuous cardiac output monitor (FloTrac sensor) for measuring cardiac index in children with congenital heart disease undergoing cardiac catheterization. Cardiac index is a critical hemodynamic parameter measured during catheterizations in children with congenital heart disease. This has been challenging to measure accurately and many clinicians rely on predictive equations for calculating cardiac index.
Design: Prospective, nonrandomized trial.
Setting: Tertiary care congenital heart center.
Patients: Consecutive participants ≤18 years old undergoing clinically indicated cardiac catheterizations from September 2014 through August 2015.
Interventions: Oxygen consumption was measured using the Vmax Encore 229 monitor attached to the ventilator circuit. The FloTrac transducer with third generation software was connected to a pigtail catheter in the descending aorta and cardiac index was obtained.
Outcome Measures: Cardiac index by the Fick equation using measured oxygen consumption was compared to cardiac index from the FloTrac sensor using paired t-test and Bland–Altman analysis.
Results: 39 participants (median age 5.1 years, 1.5-18.3, 64% female) were studied. Cardiac index by FloTrac was higher than cardiac index by Fick (6.4 ± 3.4 vs 3.7 ± 1.2 L/min/m2, P < .001). Bland–Altman analysis showed a consistent overestimation of cardiac index by FloTrac which worsened as cardiac index increased (mean bias 2.7 L/min/m2 , 95% limits of agreement 24.2, 9.5).
Conclusions: The results of this study show that the FloTrac sensor provides cardiac index measures which are not accurate enough to justify use in children with congenital heart disease undergoing catheterization. Further studies may allow for modifications of the algorithms to obtain more accurate cardiac index in this population.

Keywords

catheterization, congenital heart disease, diagnostic, hemodynamics, pediatrics

Cite This Article

Seckeler, M. D., Typpo, K., Deschenes, J., Higgins, R., Samson, R. et al. (2017). Inaccuracy of a continuous arterial pressure waveform monitor when used for congenital cardiac catheterization. Congenital Heart Disease, 12(6), 815–819.



This work is licensed under a Creative Commons Attribution 4.0 International License , which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
  • 938

    View

  • 758

    Download

  • 0

    Like

Share Link

WeChat scan