Clinical evaluation of the FloTrac/Nigileo™ system and two established continuous cardiac output monitoring devices in patients undergoing cardiac surgery

Background. Assessment of cardiac output (CO) by the FloTrac/Vigileo(TM) system may offer a less invasive means of determining the CO than either the pulmonary artery catheter (PAC) or the PiCCOplus(TM) system. The aim of this study was to compare CO measurements made using the FloTrac/Vigileo(TM) system with upgraded software (FCO, Edwards Lifesciences, Irvine CA, USA), the PiCCOplus(TM) system (PCO, Pulsion Medical Systems, Munich, Germany) and continuous CO monitoring using a PAC (CCO; Vigilance(TM) monitoring, Edwards Lifesciences, Irvine CA, USA) with intermittent pulmonary artery thermodilution (ICO). The study was conducted in patients undergoing elective cardiac surgery. Methods. Thirty-one patients with preserved left ventricular function were enrolled. CCO, FCO, and PCO were recorded in the perioperative period at six predefined time points after achieving stable haemodynamic conditions; ICO was determined from the mean of three bolus injections. Bland-Altman analysis was used to compare CCO, FCO, and PCO with ICO. Results. Bland-Altman analysis revealed a comparable mean bias and limits of agreement for all tested continuous CO monitoring devices using ICO as reference method. Agreement for all devices decreased in the postoperative period. Conclusion. The performance of the FloTrac/Vigileo(TM) system, the PiCCOplus(TM), and the Vigilance(TM) CCO monitoring for CO measurement were comparable when tested against intermittent thermodilution in patients undergoing elective cardiac surgery.