Automated echocardiography for measuring and tracking cardiac output after cardiac surgery: a validation study
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ORIGINAL RESEARCH
Automated echocardiography for measuring and tracking cardiac output after cardiac surgery: a validation study Peter Juhl‑Olsen1,2 · Søren H. Smith1 · Anders M. Grejs3 · Martin R. S. Jørgensen1 · Rajesh Bhavsar4 · Simon T. Vistisen1,2 Received: 17 April 2019 / Accepted: 25 October 2019 © Springer Nature B.V. 2019
Abstract Echocardiographic measurement of cardiac output with automated software analyses of spectral curves in the left ventricular outflow tract has been introduced. This study aimed to assess the precision and accuracy of cardiac output measurements as well as the ability to track cardiac output changes over time comparing the automated echocardiographic method with the continuous pulmonary artery thermodilution cardiac output technique and the manual echocardiographic method in cardiac surgery patients. Cardiac output was measured simultaneously with all three methods in 50 patients on the morning after cardiac surgery. A second comparison was performed 90–180 min later. Precisions for each method were measured. Bias and limits of agreement (LoA) between methods were assessed and concordance- and polar plots were used for evaluating trending of cardiac output. When comparing the automated echocardiographic method with the thermodilution technique, the mean bias was 0.72 L/min with LoA − 1.89; 3.33 L/min corresponding to a percentage error of 46%. The concordance rate was 47%. The mean bias between the automated- and the manual echocardiographic methods was − 0.06 L/min (95% LoA − 2.33; 2.21 L/min, percentage error 42%). The concordance rate was 79%. The automated echocardiographic method did not meet the criteria for interchangeability with the thermodilution technique or the manual echocardiographic method. Trending ability was poor when compared to the continuous thermodilution technique, but moderate when compared to the manual echocardiographic method. Trial registry number: NCT03372863. Retrospectively registered December 14th 2017. Keywords Cardiac output · Echocardiography · Ultrasonography · Thoracic surgery · Haemodynamics List of abbreviations CCO Continuous cardiac output CI Confidence interval CO Cardiac output Electronic supplementary material The online version of this article (https://doi.org/10.1007/s10877-019-00413-w) contains supplementary material, which is available to authorized users. * Peter Juhl‑Olsen peter.juhl‑[email protected] 1
Department of Anaesthesiology, Aarhus University Hospital, Palle Juul‑Jensens Boulevard 99, 8200 Aarhus, Denmark
2
Department of Clinical Medicine, Aarhus University, Palle Juul‑Jensens Boulevard 82, 8200 Aarhus, Denmark
3
Department of Intensive Care, Aarhus University Hospital, Palle Juul‑Jensens Boulevard 99, 8200 Aarhus, Denmark
4
Department of Anaesthesiology & Intensive Care, Hospital of Southern Jutland, Kresten Philipsens Vej 15, 6200 Aabenraa, Denmark
CV Coefficient of variation LoA Limits of agreement LVOT Left ventricular outflow tract PAC Pulmonary artery catheter ROI Region of interest V
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