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Comparison of the ability of two continuous cardiac output monitors to detect stroke volume index: Estimated continuous cardiac output estimated by modified pulse wave transit time and measured by an arterial pulse contour-based cardiac output device.

BACKGROUND
Estimated continuous cardiac output (esCCO), a non-invasive technique for continuously measuring cardiac output (CO), is based on modified pulse wave transit time, which is determined by pulse oximetry and electrocardiography.


OBJECTIVE
We examined the ability of esCCO to detect stroke volume index (SVI) and changes in SVI compared with currently available arterial waveform analysis methods.


METHODS
We retrospectively reanalysed 15 of the cases from our previous study on esCCO measurement. SVI was calculated using an esCCO system, measured using the arterial pressure-based CO (APCO) method, and compared with a corresponding intermittent bolus thermodilution CO (ICO) method. Percentage error measurement and statistical methods, including concordance analysis and polar plot analysis, were performed.


RESULTS
The difference in the SVI values between esCCO and ICO was -3.0 ± 8.8 ml (percentage error, 33.5%). The mean angular bias was 0.8 and the radial limits of agreement were ± 27.3. The difference in the SVI values between APCO and ICO was 0.9 ± 11.2 ml (percentage error, 42.6%). The mean angular bias was -6.8 and the radial limits of agreement were ± 44.1.


CONCLUSION
This study demonstrated that the accuracy, precision, and dynamic trend of esCCO are better than those of APCO.