A Review of Intraoperative Goal-Directed Therapy Using Arterial Waveform Analysis for Assessment of Cardiac Output

Table 1

Overview of the different arterial waveform analysis systems.

	FloTrac	LiDCO	PiCCO
Method of analysis	Standard deviation of arterial pulse pressure around the mean arterial pressure	Pulse power analysis	Pulse contour analysis
Calibration	Not needed	Manual—lithium dilution (not needed in LiDCO rapid)	Manual—thermodilution with saline or glucose
Requirements	Peripheral or central arterial	Peripheral or central arterial	Central arterial and central venous
Advantages	Minimally invasive, easy to use, and no calibration	Minimally invasive, easy to use, no calibration with LiDCO rapid, more accurate with hemodynamic instability, and waveform shape does not matter	More accurate with hemodynamic instability, additional data available (extravascular lung volume and intrathoracic blood volume)
Disadvantages	Not as reliable with hemodynamic instability since peripheral vascular resistance is included in the conversion factor	Not as accurate when patient receive lithium therapy or certain neuromuscular blocking agents	More invasive, shape of arterial waveform matters