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197: PULSE PRESSURE VARIATION DERIVED FROM THE GENERAL MONITOR CARESCAPE B850 VS. PICCO-DERIVED PPV_PICCO

Introduction/Hypothesis: Several studies suggest that pulse pressure variation PPV better predicts fluid responsiveness compared to filling pressures and other static markers of preload. Numerous less and non-invasive devices provide assessment of PPV. Most of these devices directly process signals from the arterial pressure curve based on pulse-contour-analysis (PCA). Although they are less invasive than pulmonary arterial and transpulmonary thermodilution, most PCA-technologies require expensive monitors (≥10,000 USD) and disposables (≥80 USD). Therefore, their availability and use are restricted. Interestingly, also the standard general monitoring system Carescape B850 (GE Healthcare; USA) provides „for free” PPV_GE derived from a conventional radial or femoral arterial line and a standard pressure transducer. To the best of our knowledge, PPV_GE has not yet been validated vs. established stand-alone technologies to derive PPV. Methods: Therefore, it was the aim of our study to compare PPV_GE vs. the gold-standard PPV_PiCCO which was derived from femoral artery by PCA with the PiCCO (Pulsion, Germany). Statistics: Wilcoxon-test; Bland-Altman-analysis; Kendall-tau-b-correlation regarding classifications of PPV<9%; PPV 9-13% and PPV>13. IBM SPSS 26. Results: We performed a total of 159 comparisons of PPV_GE and PPV_PiCCO in 22 patients (APACHE-II 25±4; SOFA 11±3) with PiCCO-monitoring. The PiCCO-monitor routinely transfers the signal of the arterial pressure curve to a standard monitor such as the GE Carescape B850. PPV_GE and PPV_PiCCO were slightly different (6.1±5.5% vs. 7.1±5.1%; p<0.001). Classifications associated with fluid responiveness (PPV>13%), no fluid responsiveness (PPV<9%) and „gray zone” (9-13%) are considered more important than absolute values of PPV. Comparison of categorization of PPV_GE and GE_PiCCO demonstrated an acceptable agreement of 123 out of 159 (77%). In 5 of 159 (3%) measurements the categorization of PPV_GE and PPV_PiCCO was completely opposite (<9% instead of >13% and vice-versa). The Kendall-tau-b coefficient of correlation was in the acceptable range (r=0.615; p<0.001). Conclusions: The GE Carescape B850 monitor provides PPV_ GE which is comparable to PPV_PiCCO from a standard stand-alone monitor PiCCO-2. PPV-derived „for free” by general monitors is promising and cost-saving.