Skip to main content

Advertisement

SpringerLink
Log in

Accuracy and trending ability of the fourth-generation FloTrac/Vigileo System™ in patients undergoing abdominal aortic aneurysm surgery

  • Original Article
  • Published:
Journal of Anesthesia Aims and scope Submit manuscript

Abstract

Purpose

The fourth-generation FloTrac/Vigileo™ improved its algorithm to follow changes in systemic vascular resistance index (SVRI). This revision may improve the accuracy and trending ability of CI even in patients who undergo abdominal aortic aneurysm (AAA) surgery which cause drastic change of SVRI by aortic clamping. The purpose of this study is to elucidate the accuracy and trending ability of the fourth-generation FloTrac/Vigileo™ in patients with AAA surgery by comparing the FloTrac/Vigileo™-derived CI (CIFT) with that measured by three-dimensional echocardiography (CI3D).

Methods

Twenty-six patients undergoing elective AAA surgery were included in this study. CIFT and CI3D were determined simultaneously in eight points including before and after aortic clamp. We used CI3D as the reference method.

Results

In the Bland–Altman analysis, CIFT had a wide limit of agreement with CI3D showing a percentage error of 46.7%. Subgroup analysis showed that the percentage error between CO3D and COFT was 56.3% in patients with cardiac index < 2.5 L/min/m2 and 28.4% in patients with cardiac index ≥ 2.5 L/min/m2. SVRI was significantly higher in patients with cardiac index < 2.5 L/min/m2 (1703 ± 330 vs. 2757 ± 798; p < 0.001). The tracking ability of fourth generation of FloTrac/Vigileo™ after aortic clamp was not clinically acceptable (26.9%).

Conclusions

The degree of accuracy of the fourth-generation FloTrac/Vigileo™ in patients with AAA surgery was not acceptable. The tracking ability of the fourth-generation FloTrac/Vigileo™ after aortic clamp was below the acceptable limit.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1
Fig. 2
Fig. 3
Fig. 4

Similar content being viewed by others

References

  1. Mor-Avi V, Jenkins C, Kühl HP, Nesser HJ, Marwick T, Franke A, Ebner C, Freed BH, Steringer-Mascherbauer R, Pollard H, Weinert L, Niel J, Sugeng L, Lang RM. Real-time 3-dimensional echocardiographic quantification of left ventricular volumes: multicenter study for validation with magnetic resonance imaging and investigation of sources of error. JACC Cardiovasc Imaging. 2008;1:413–23.

    Article  PubMed  Google Scholar 

  2. Mor-Avi V, Sugeng L, Lang RM. Real-time 3-dimensional echocardiography: an integral component of the routine echocardiographic examination in adult patients? Circulation. 2009;119:314–29.

    Article  PubMed  Google Scholar 

  3. Shimada YJ, Ishikawa K, Kawase Y, Ladage D, Tilemann L, Shiota T, Hajjar RJ. Comparison of left ventricular stroke volume assessment by two- and three-dimensional echocardiography in a swine model of acute myocardial infarction validated by thermodilution method. Echocardiography. 2012;29:1091–5.

    Article  PubMed  Google Scholar 

  4. Jenkins C, Bricknell K, Hanekom L, Marwick TH. Reproducibility and accuracy of echocardiographic measurements of left ventricular parameters using real-time three-dimensional echocardiography. J Am Coll Cardiol. 2004;44:878–86.

    Article  PubMed  Google Scholar 

  5. Balluz R, Liu L, Zhou X, Ge S. Real time three-dimensional echocardiography for quantification of ventricular volumes, mass, and function in children with congenital and acquired heart diseases. Echocardiography. 2013;30:472–82.

    Article  PubMed  Google Scholar 

  6. Jakubovic BD, Wald R, Goldstein MB, Leong-Poi H, Yuen DA, Perl J, Lima JA, Liu JJ, Kirpalani A, Dacouris N, Wald R, Connelly KA, Yan AT. Comparative assessment of 2-dimensional echocardiography vs cardiac magnetic resonance imaging in measuring left ventricular mass in patients with and without end-stage renal disease. Can J Cardiol. 2013;29:384–90.

    Article  PubMed  Google Scholar 

  7. Maeda T, Yoshitani K, Inatomi Y, Ohnishi Y. Inaccuracy of the FloTrac/Vigileo system in patients with low cardiac index. J Cardiothorac Vasc Anesth. 2014;28:1521–6.

    Article  PubMed  Google Scholar 

  8. McNamara H, Barclay P, Sharma V. Accuracy and precision of the ultrasound cardiac output monitor (USCOM 1A) in pregnancy: comparison with three-dimensional transthoracic echocardiography. Br J Anaesth. 2014;113:669–76.

    Article  PubMed  CAS  Google Scholar 

  9. Maeda T, Sakurai R, Nakagawa K, Morishima K, Maekawa M, Furumoto K, Kono T, Egawa A, Kubota Y, Kato S, Okamura H, Yoshitani K, Ohnishi Y. Cardiac resynchronization therapy-induced cardiac index increase measured by three-dimensional echocardiography can predict decreases in brain natriuretic peptide. J Cardiothorac Vasc Anesth. 2016;30:599–605.

    Article  PubMed  Google Scholar 

  10. Biancofiore G, Critchley LA, Lee A, Yang XX, Bindi LM, Esposito M, Bisà M, Meacci L, Mozzo R, Filipponi F. Evaluation of a new software version of the FloTrac/Vigileo (version 3.02) and a comparison with previous data in cirrhotic patients undergoing liver transplant surgery. Anesth Analg. 2011;113:515–22.

    PubMed  Google Scholar 

  11. Suehiro K, Tanaka K, Funao T, Matsuura T, Mori T, Nishikawa K. Systemic vascular resistance has an impact on the reliability of the Vigileo-FloTrac system in measuring cardiac output and tracking cardiac output changes. Br J Anaesth. 2013;111:170–7.

    Article  PubMed  CAS  Google Scholar 

  12. Suehiro K, Tanaka K, Mikawa M, Uchihara Y, Matsuyama T, Matsuura T, Funao T, Yamada T, Mori T, Nishikawa K. Improved performance of the fourth-generation FloTrac/Vigileo system for tracking cardiac output changes. J Cardiothorac Vasc Anesth. 2015;29:656–62.

    Article  PubMed  Google Scholar 

  13. Kusaka Y, Yoshitani K, Irie T, Inatomi Y, Shinzawa M, Ohnishi Y. Clinical comparison of an echocardiograph-derived versus pulse counter-derived cardiac output measurement in abdominal aortic aneurysm surgery. J Cardiothorac Vasc Anesth. 2012;26:223–6.

    Article  PubMed  Google Scholar 

  14. Hattori K, Maeda T, Masubuchi T, Yoshikawa A, Ebuchi K, Morishima K, Kamei M, Yoshitani K, Ohnishi Y. Accuracy and trending ability of the fourth-generation FloTrac/Vigileo system in patients with low cardiac index. J Cardiothorac Vasc Anesth. 2017;31:99–104.

    Article  PubMed  Google Scholar 

  15. Langewouters GJ, Wesseling KH, Goedhard WJ. The pressure dependent dynamic elasticity of 35 thoracic and 16 abdominal human aortas in vitro described by a five component model. J Biomech. 1985;18:613–20.

    Article  PubMed  CAS  Google Scholar 

  16. Bland JM, Altman DG. Statistical methods for assessing agreement between two methods of clinical measurement. Lancet. 1986;1:307–10.

    Article  PubMed  CAS  Google Scholar 

  17. Critchley LA, Critchley JA. A meta-analysis of studies using bias and precision statistics to compare cardiac output measurement techniques. J Clin Monit Comput. 1999;15:85–91.

    Article  PubMed  CAS  Google Scholar 

  18. Critchley LA, Yang XX, Lee A. Assessment of trending ability of cardiac output monitors by polar plot methodology. J Cardiothorac Vasc Anesth. 2011;25:536–46.

    Article  PubMed  Google Scholar 

  19. Critchley LA, Lee A, Ho AM. A critical review of the ability of continuous cardiac output monitors to measure trends in cardiac output. Anesth Analg. 2010;111:1180–92.

    Article  PubMed  Google Scholar 

  20. Ji F, Li J, Fleming N, Rose D, Liu H. Reliability of a new 4th generation FloTrac algorithm to track cardiac output changes in patients receiving phenylephrine. J Clin Monit Comput. 2015;29:467–73.

    Article  PubMed  Google Scholar 

  21. Lin SY, Chou AH, Tsai YF, Chang SW, Yang MW, Ting PC, Chen CY. Evaluation of the use of the fourth version FloTrac system in cardiac output measurement before and after cardiopulmonary bypass. J Clin Monit Comput. 2017. https://doi.org/10.1007/s10877-017-0071-6

    Article  PubMed  Google Scholar 

  22. Vincent JL. Understanding cardiac output. Crit Care. 2008;12:174.

    Article  PubMed  PubMed Central  Google Scholar 

  23. Zoghbi WA, Enriquez-Sarano M, Foster E, Grayburn PA, Kraft CD, Levine RA, Nihoyannopoulos P, Otto CM, Quinones MA, Rakowski H, Stewart WJ, Waggoner A, Weissman NJ. Recommendations for evaluation of the severity of native valvular regurgitation with two-dimensional and Doppler echocardiography. J Am Soc Echocardiogr. 2003;16:777–802.

    Article  PubMed  Google Scholar 

Download references

Acknowledgements

We thank Jane Charbonneau, DVM, from Edanz Group (www.edanzediting.com/ac) for editing a draft of this manuscript. We are also grateful to the resident doctors who cared for the patients in this study, for their cooperation. This research was supported in part by JSPS KAKENHI Grant Number JP17K11100.

Author information

Authors and Affiliations

  1. Department of Anesthesiology, National Cerebral and Cardiovascular Center, 5-7-1 Fujishirodai, Suita, Osaka, 565-8565, Japan

    Takuma Maeda, Miho Sumiyoshi, Hiroko Kanazawa & Yoshihiko Ohnishi

  2. Division of Transfusion Medicine, National Cerebral and Cardiovascular Center, 5-7-1 Fujishirodai, Suita, Osaka, 565-8565, Japan

    Takuma Maeda

  3. Anesthesilogy and Pain Relief Center, The University of Tokyo, Tokyo, Japan

    Kohshi Hattori

Authors
  1. Takuma Maeda
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Kohshi Hattori
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Miho Sumiyoshi
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Hiroko Kanazawa
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Yoshihiko Ohnishi
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Takuma Maeda.

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Maeda, T., Hattori, K., Sumiyoshi, M. et al. Accuracy and trending ability of the fourth-generation FloTrac/Vigileo System™ in patients undergoing abdominal aortic aneurysm surgery. J Anesth 32, 387–393 (2018). https://doi.org/10.1007/s00540-018-2491-y

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00540-018-2491-y

Keywords

Search

Navigation