Impact of changes in systemic vascular resistance on a novel non-invasive continuous cardiac output measurement system based on pulse wave transit time: a report of two cases

The inaccuracy of arterial waveform analysis for measuring continuos cardiac output (CCO) associated with changes in systemic vascular resistance (SVR) has been well documented. A new non-invasive continuous cardiac output monitoring system (esCCO) mainly utilizing pulse wave transit time (PWTT) in place of arterial waveform analysis has been developed. However, the trending ability of esCCO to measure cardiac output during changes in SVR remains unclear. After a previous multicenter study on esCCO measurement, we retrospectively identified two cases in which apparent changes in SVR developed in a short period during data collection. In each case, the trending ability of esCCO to measure cardiac output and time component of PWTT were analyzed. Recorded data suggest that the time component of PWTT may have a significant impact on the accuracy of estimating stroke volume during changes in SVR. However, further prospective clinical studies are required to test this hypothesis.

[1]  J. Takeda,et al.  The ability of a new continuous cardiac output monitor to measure trends in cardiac output following implementation of a patient information calibration and an automated exclusion algorithm , 2012, Journal of Clinical Monitoring and Computing.

[2]  J. Takeda,et al.  Multicenter Study Verifying a Method of Noninvasive Continuous Cardiac Output Measurement Using Pulse Wave Transit Time: A Comparison with Intermittent Bolus Thermodilution Cardiac Output , 2012, Anesthesia and analgesia.

[3]  C. Leier,et al.  Effect of afterload on left ventricular performance in experimental animals. Comparison of the pre-ejection period and other indices of left ventricular contractility. , 1982, Journal of medicine.

[4]  W. B. Murray,et al.  The peripheral pulse wave: Information overlooked , 1996, Journal of clinical monitoring.

[5]  M. Cannesson,et al.  The Impact of Phenylephrine, Ephedrine, and Increased Preload on Third-Generation Vigileo-FloTrac and Esophageal Doppler Cardiac Output Measurements , 2011, Anesthesia and analgesia.

[6]  Hironori Ishihara,et al.  A novel continuous cardiac output monitor based on pulse wave transit time , 2010, 2010 Annual International Conference of the IEEE Engineering in Medicine and Biology.

[7]  B. Bengtsson,et al.  Acute Haemodynamic Effects of Felodipine and Verapamil in Man, Singly and with Metoprolol , 2012, Drugs.

[8]  S. D. De Hert,et al.  Uncalibrated arterial pulse contour analysis versus continuous thermodilution technique: effects of alterations in arterial waveform. , 2007, Journal of cardiothoracic and vascular anesthesia.

[9]  The Relationship Between Effective Arterial Capacitance and Pulse Wave Velocity Is Dependent on Left Ventricular Stroke Volume , 2009, Angiology.

[10]  A. Steptoe,et al.  Pulse wave velocity as a measure of blood pressure change. , 1976, Psychophysiology.