Table of Contents Author Guidelines Submit a Manuscript
BioMed Research International
Volume 2017, Article ID 2635151, 8 pages
Clinical Study

Accuracy, Precision, and Trending Ability of Electrical Cardiometry Cardiac Index versus Continuous Pulmonary Artery Thermodilution Method: A Prospective, Observational Study

1Department of Anesthesiology and Pain Management, Maastricht University Medical Center+, Prof. Debyelaan 25, 6202 AZ Maastricht, Netherlands
2Department of Anesthesiology and ICU, St. Antonius Ziekenhuis, Postbus 2500, 3430 EM Nieuwegein, Netherlands
3Department of Anesthesiology, University Medical Centre Utrecht, Heidelberglaan 100, 3584 CX Utrecht, Netherlands
4Department of Anesthesiology, ICU and Perioperative Medicine, HMC, P.O. Box 3050, Doha, Qatar

Correspondence should be addressed to P. B. W. Cox; ln.cmum@xoc.b

Received 28 April 2017; Revised 21 July 2017; Accepted 20 August 2017; Published 9 October 2017

Academic Editor: Kazunori Uemura

Copyright © 2017 P. B. W. Cox et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.


Introduction. Evaluation of accuracy, precision, and trending ability of cardiac index (CI) measurements using the Aesculon™ bioimpedance electrical cardiometry (Aesc) compared to the continuous pulmonary artery thermodilution catheter (PAC) technique before, during, and after cardiac surgery. Methods. A prospective observational study with fifty patients with ASA 3-4. At six time points (T), measurements of CI simultaneously by continuous cardiac output pulmonary thermodilution and thoracic bioimpedance and standard hemodynamics were performed. Analysis was performed using Bland-Altman, four-quadrant plot, and polar plot methodology. Results. CI obtained with pulmonary artery thermodilution and thoracic bioimpedance ranged from 1.00 to 6.75 L min−1 and 0.93 to 7.25 L min−1, respectively. Bland-Altman analysis showed a bias between and of 0.52 liters min−1 m−2, with LOA of [−2.2; 1.1] liters min−1 m−2. Percentage error between the two techniques was above 30% at every time point. Polar plot methodology and 4-quadrant analysis showed poor trending ability. Skin incision had no effect on the results. Conclusion. CI obtained by continuous PAC and CI obtained by Aesculon bioimpedance are not interchangeable in cardiac surgical patients. No effects of skin incision were found. International clinical trial registration number is ISRCTN26732484.