{Reference Type}: Journal Article
{Title}: Bias, trending ability and diagnostic performance of a non-calibrated multi-beat analysis continuous cardiac output monitor to identify fluid responsiveness in critically ill patients.
{Author}: Bitker L;Noirot I;Chauvelot L;Mezidi M;Dhelft F;Gaillet M;Yonis H;Deniel G;Richard JC;
{Journal}: Crit Care Resusc
{Volume}: 26
{Issue}: 2
{Year}: 2024 Jun
{Factor}: 5.692
{DOI}: 10.1016/j.ccrj.2024.04.003
{Abstract}: <B>UNASSIGNED: </B>To evaluate the accuracy of non-calibrated multi-beat analysis continuous cardiac output (CCOMBA), against calibrated pulse-contour analysis continuous cardiac output (CCOPCA) during a passive leg raise (PLR) and/or a fluid challenge (FC).<BR><B>UNASSIGNED: </B>Observational, single-centre, prospective study.<BR><B>UNASSIGNED: </B>Tertiary academic medical intensive care unit, Lyon, France.<BR><B>UNASSIGNED: </B>Adult patients receiving norepinephrine, monitored by CCOPCA, and in which a PLR and/or a FC was indicated.<BR><B>UNASSIGNED: </B>CCOMBA and CCOPCA were recorded prior to and during the PLR/FC to evaluate bias and evaluate changes in CCOMBA and CCOPCA (∆%CCOMBA and ∆%CCOPCA). Fluid responsiveness was identified by an increase >15% in calibrated cardiac output after FC, to identify the optimal ∆%CCOMBA threshold during PLR to predict fluid responsiveness.<BR><B>UNASSIGNED: </B>29 patients (median age 68 [IQR: 57-74]) performed 28 PLR and 16 FC. The bias between methods increased with higher CCOPCA values, with a percentage error of 64% (95%confidence interval: 52%-77%). ∆%CCOMBA adequately tracked changes in ∆%CCOPCA with an angular bias of 2 ± 29°. ∆%CCOMBA during PLR had an AUROC of 0.92 (P < 0.05), with an optimal threshold >14% to predict fluid responsiveness (sensitivity: 0.99, specificity: 0.87).<BR><B>UNASSIGNED: </B>CCOMBA showed a non-constant bias and a percentage error >30% against calibrated CCOPCA, but an adequate ability to track changes in CCOPCA and to predict fluid responsiveness.