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The Scientific World Journal
Volume 2013, Article ID 519080, 11 pages
Research Article

Nexfin Noninvasive Continuous Hemodynamic Monitoring: Validation against Continuous Pulse Contour and Intermittent Transpulmonary Thermodilution Derived Cardiac Output in Critically Ill Patients

1Department of Intensive Care Medicine, Ziekenhuis Netwerk Antwerpen, ZNA Stuivenberg, Lange Beeldekensstraat 267, 2060 Antwerp, Belgium
2Department of Anaesthesiology and Intensive Care Medicine, University Hospital Schleswig-Holstein, Campus Kiel, Schwanenweg 21, 24105 Kiel, Germany

Received 13 July 2013; Accepted 15 September 2013

Academic Editors: L. M. Gillman, D. Karakitsos, A. E. Papalois, and A. Shiloh

Copyright © 2013 Koen Ameloot 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. Nexfin (Bmeye, Amsterdam, Netherlands) is a noninvasive cardiac output (CO) monitor based on finger arterial pulse contour analysis. The aim of this study was to validate Nexfin CO (NexCO) against thermodilution (TDCO) and pulse contour CO (CCO) by PiCCO (Pulsion Medical Systems, Munich, Germany). Patients and Methods. In a mix of critically ill patients ( ), NexCO and CCO were measured continuously and recorded at 2-hour intervals during the 8-hour study period. TDCO was measured at 0–4–8 hrs. Results. NexCO showed a moderate to good (significant) correlation with TDCO ( 0.68, ) and CCO ( 0.71, ). Bland and Altman analysis comparing NexCO with TDCO revealed a bias (± limits of agreement, LA) of 0.4 ± 2.32 L/min (with 36% error) while analysis comparing NexCO with CCO showed a bias (±LA) of 0.2 ± 2.32 L/min (37% error). NexCO is able to follow changes in TDCO and CCO during the same time interval (level of concordance 89.3% and 81%). Finally, polar plot analysis showed that trending capabilities were acceptable when changes in NexCO ( NexCO) were compared to TDCO and CCO (resp., 89% and 88.9% of changes were within the level of 10% limits of agreement). Conclusion. we found a moderate to good correlation between CO measurements obtained with Nexfin and PiCCO.