- 期刊
Agreement of a Non-Invasive Continuous Hemodynamic Monitoring System ClearSight^(TM) during Anesthesia in Prone Position: Concordance Correlation with a Standard Minimally-Invasive Pulse Contour Method
摘要
Objective: Recent clinical studies have suggested that non-invasive pulse wave analysis (PWA) devices can be an alternative to minimally invasive PWA devices for hemodynamic measurement during major or high-risk operations. However, the agreement of these two systems has not been previously characterized in operations that requires prone positioning. Methods: This prospective case-based observational study recruited patients that underwent lumbar spine surgery in the prone kneeling position. All patients received minimally invasive Flotrac/EV1000 and non-invasive ClearSight systems for continuous intraoperative hemodynamic measurements. Bland-Altman plots and Lin's concordance correlation coefficient (CCC) were used to analyze the agreements between the two systems. Results: A total of 30 patients were included in this study. Both systems showed considerably less bias in measuring mean pressure and high accuracy in measuring stroke volume variation (SVV) in the prone position (Cb 0.98-0.99). However, the agreements in cardiac output (CO) measurement using the ClearSight were relatively low (CCC < 0.65) and the overall 95% limit of agreement reached negative values, as 35.3% of low cardiac index (CI) (< 2.5 L/min/m^2) measured by the Flotrac was shown as normal-to-high CI (≥ 2.6 L/min/m^2) in the ClearSight. Conclusion: Compared with minimally invasive PWA device, ClearSight provided clinically acceptable mean pressure and reasonably consistent SVV values for optimization of intravascular volume in non-critical patients in the prone position during lumbar spine surgery. However, perioperative data from patients in prone position should be interpreted with caution, as CO is likely to be overestimated by the ClearSight than the Flotrac.
參考文獻
延伸閱讀
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