Clinical evaluation of a new tracheal impedance cardiography method
Summary Non‐invasive cardiac output measurement by means of impedance cardiography has been evaluated before, and agreement with other methods has been variable. We decided to study a newly developed tracheal impedance device, that is claimed to be more accurate and reliable. This incorporates new s...
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| Veröffentlicht in: | Anaesthesia 2012-07, Vol.67 (7), p.729-733 |
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| creator | van der Kleij, S. C. J. Koolen, B. B. Newhall, D. A. Gerritse, B. M. Rosseel, P. M. J. Rijpstra, T. A. Geisler, F. E. A. van der Meer, N. J. M. |
| description | Summary
Non‐invasive cardiac output measurement by means of impedance cardiography has been evaluated before, and agreement with other methods has been variable. We decided to study a newly developed tracheal impedance device, that is claimed to be more accurate and reliable. This incorporates new software and mathematical formulae, that are designed to reduce signal noise from diathermy, leading to improved accuracy. In 25 cardiothoracic surgery patients, simultaneous measurements were performed using both pulmonary artery thermodilution and the tracheal impedance device, at five peri‐operative time points: before skin incision; after weaning from cardiopulmonary bypass; after sternal closure; and 30 min and 2 h after arrival in the intensive care unit. Mean cardiac output, bias and 95% limits of agreement were 5.3, 0.03 and −2.8 to 2.8 l.min−1, respectively. Tracheal impedance showed good correlation with measurement trends using thermodilution in 88% of measurements, with a mean (95% limit of agreement) angular bias of −9.0° (−83.3 to 65.3°). However, the wide limits of agreement and high percentage error of 53% that were apparent in this study mean that, in its present guise, tracheal impedance is not an acceptable alternative to thermodilution in cardiac surgical patients. |
| doi_str_mv | 10.1111/j.1365-2044.2012.07089.x |
| format | Article |
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Non‐invasive cardiac output measurement by means of impedance cardiography has been evaluated before, and agreement with other methods has been variable. We decided to study a newly developed tracheal impedance device, that is claimed to be more accurate and reliable. This incorporates new software and mathematical formulae, that are designed to reduce signal noise from diathermy, leading to improved accuracy. In 25 cardiothoracic surgery patients, simultaneous measurements were performed using both pulmonary artery thermodilution and the tracheal impedance device, at five peri‐operative time points: before skin incision; after weaning from cardiopulmonary bypass; after sternal closure; and 30 min and 2 h after arrival in the intensive care unit. Mean cardiac output, bias and 95% limits of agreement were 5.3, 0.03 and −2.8 to 2.8 l.min−1, respectively. Tracheal impedance showed good correlation with measurement trends using thermodilution in 88% of measurements, with a mean (95% limit of agreement) angular bias of −9.0° (−83.3 to 65.3°). However, the wide limits of agreement and high percentage error of 53% that were apparent in this study mean that, in its present guise, tracheal impedance is not an acceptable alternative to thermodilution in cardiac surgical patients.</description><identifier>ISSN: 0003-2409</identifier><identifier>EISSN: 1365-2044</identifier><identifier>DOI: 10.1111/j.1365-2044.2012.07089.x</identifier><identifier>PMID: 22420758</identifier><identifier>CODEN: ANASAB</identifier><language>eng</language><publisher>Oxford, UK: Blackwell Publishing Ltd</publisher><subject>Aged ; Anesthesia ; Anesthesia. Intensive care medicine. Transfusions. Cell therapy and gene therapy ; Biological and medical sciences ; Cardiac Output ; Cardiography, Impedance - instrumentation ; Cardiography, Impedance - methods ; Cardiopulmonary Bypass ; Coronary Artery Bypass ; Electrocardiography ; Female ; Heart surgery ; Humans ; Male ; Medical equipment ; Medical sciences ; Middle Aged ; Monitoring, Intraoperative - instrumentation ; Monitoring, Intraoperative - methods ; Monitoring, Physiologic - instrumentation ; Monitoring, Physiologic - methods ; Perioperative Care - instrumentation ; Perioperative Care - methods ; Pilot Projects ; Postoperative Care - methods ; Pulmonary Artery - physiopathology ; Reproducibility of Results ; Thermodilution - methods</subject><ispartof>Anaesthesia, 2012-07, Vol.67 (7), p.729-733</ispartof><rights>Anaesthesia © 2012 The Association of Anaesthetists of Great Britain and Ireland</rights><rights>2015 INIST-CNRS</rights><rights>Anaesthesia © 2012 The Association of Anaesthetists of Great Britain and Ireland.</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c5449-6b65f6cb8cf3a016d801f87c3e474678a3001444e9c34083e4f5f923a0626d2c3</citedby><cites>FETCH-LOGICAL-c5449-6b65f6cb8cf3a016d801f87c3e474678a3001444e9c34083e4f5f923a0626d2c3</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://onlinelibrary.wiley.com/doi/pdf/10.1111%2Fj.1365-2044.2012.07089.x$$EPDF$$P50$$Gwiley$$H</linktopdf><linktohtml>$$Uhttps://onlinelibrary.wiley.com/doi/full/10.1111%2Fj.1365-2044.2012.07089.x$$EHTML$$P50$$Gwiley$$H</linktohtml><link.rule.ids>314,780,784,1417,1433,27924,27925,45574,45575,46409,46833</link.rule.ids><backlink>$$Uhttp://pascal-francis.inist.fr/vibad/index.php?action=getRecordDetail&idt=25982972$$DView record in Pascal Francis$$Hfree_for_read</backlink><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/22420758$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>van der Kleij, S. C. J.</creatorcontrib><creatorcontrib>Koolen, B. B.</creatorcontrib><creatorcontrib>Newhall, D. A.</creatorcontrib><creatorcontrib>Gerritse, B. M.</creatorcontrib><creatorcontrib>Rosseel, P. M. J.</creatorcontrib><creatorcontrib>Rijpstra, T. A.</creatorcontrib><creatorcontrib>Geisler, F. E. A.</creatorcontrib><creatorcontrib>van der Meer, N. J. M.</creatorcontrib><title>Clinical evaluation of a new tracheal impedance cardiography method</title><title>Anaesthesia</title><addtitle>Anaesthesia</addtitle><description>Summary
Non‐invasive cardiac output measurement by means of impedance cardiography has been evaluated before, and agreement with other methods has been variable. We decided to study a newly developed tracheal impedance device, that is claimed to be more accurate and reliable. This incorporates new software and mathematical formulae, that are designed to reduce signal noise from diathermy, leading to improved accuracy. In 25 cardiothoracic surgery patients, simultaneous measurements were performed using both pulmonary artery thermodilution and the tracheal impedance device, at five peri‐operative time points: before skin incision; after weaning from cardiopulmonary bypass; after sternal closure; and 30 min and 2 h after arrival in the intensive care unit. Mean cardiac output, bias and 95% limits of agreement were 5.3, 0.03 and −2.8 to 2.8 l.min−1, respectively. Tracheal impedance showed good correlation with measurement trends using thermodilution in 88% of measurements, with a mean (95% limit of agreement) angular bias of −9.0° (−83.3 to 65.3°). However, the wide limits of agreement and high percentage error of 53% that were apparent in this study mean that, in its present guise, tracheal impedance is not an acceptable alternative to thermodilution in cardiac surgical patients.</description><subject>Aged</subject><subject>Anesthesia</subject><subject>Anesthesia. Intensive care medicine. Transfusions. Cell therapy and gene therapy</subject><subject>Biological and medical sciences</subject><subject>Cardiac Output</subject><subject>Cardiography, Impedance - instrumentation</subject><subject>Cardiography, Impedance - methods</subject><subject>Cardiopulmonary Bypass</subject><subject>Coronary Artery Bypass</subject><subject>Electrocardiography</subject><subject>Female</subject><subject>Heart surgery</subject><subject>Humans</subject><subject>Male</subject><subject>Medical equipment</subject><subject>Medical sciences</subject><subject>Middle Aged</subject><subject>Monitoring, Intraoperative - instrumentation</subject><subject>Monitoring, Intraoperative - methods</subject><subject>Monitoring, Physiologic - instrumentation</subject><subject>Monitoring, Physiologic - methods</subject><subject>Perioperative Care - instrumentation</subject><subject>Perioperative Care - methods</subject><subject>Pilot Projects</subject><subject>Postoperative Care - methods</subject><subject>Pulmonary Artery - physiopathology</subject><subject>Reproducibility of Results</subject><subject>Thermodilution - methods</subject><issn>0003-2409</issn><issn>1365-2044</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2012</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNqNkF1LwzAUhoMobk7_ghRE8KY1SdM0uRFGmR8w9EavQ5YmLqMfM1nd9u9N3Zzglbk54ZznJC8PABGCCQrndpGglGYxhoQkGCKcwBwynmyOwPAwOAZDCGEaYwL5AJx5v4CBZIidggHGBMM8Y0NQFJVtrJJVpD9l1cmVbZuoNZGMGr2OVk6quQ5DWy91KRulIyVdadt3J5fzbVTr1bwtz8GJkZXXF_s6Am_3k9fiMZ6-PDwV42msMkJ4TGc0M1TNmDKphIiWDCLDcpVqkhOaM5mGgIQQzVVKIAttkxmOA0sxLbFKR-Bm9-7StR-d9itRW690VclGt50XCCJOEWOcBPTqD7poO9eEdD3FKMUsZ4FiO0q51nunjVg6W0u3DZDoRYuF6H2K3qfoRYtv0WITVi_3H3SzWpeHxR-zAbjeA9IHvcYFe9b_chlnmOc4cHc7bm0rvf13ADF-Hk_6a_oFM-OWtw</recordid><startdate>201207</startdate><enddate>201207</enddate><creator>van der Kleij, S. C. J.</creator><creator>Koolen, B. B.</creator><creator>Newhall, D. A.</creator><creator>Gerritse, B. M.</creator><creator>Rosseel, P. M. J.</creator><creator>Rijpstra, T. A.</creator><creator>Geisler, F. E. A.</creator><creator>van der Meer, N. J. M.</creator><general>Blackwell Publishing Ltd</general><general>Wiley-Blackwell</general><scope>IQODW</scope><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7T5</scope><scope>7U7</scope><scope>C1K</scope><scope>H94</scope><scope>K9.</scope><scope>7X8</scope></search><sort><creationdate>201207</creationdate><title>Clinical evaluation of a new tracheal impedance cardiography method</title><author>van der Kleij, S. C. J. ; Koolen, B. B. ; Newhall, D. A. ; Gerritse, B. M. ; Rosseel, P. M. J. ; Rijpstra, T. A. ; Geisler, F. E. A. ; van der Meer, N. J. 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Cell therapy and gene therapy</topic><topic>Biological and medical sciences</topic><topic>Cardiac Output</topic><topic>Cardiography, Impedance - instrumentation</topic><topic>Cardiography, Impedance - methods</topic><topic>Cardiopulmonary Bypass</topic><topic>Coronary Artery Bypass</topic><topic>Electrocardiography</topic><topic>Female</topic><topic>Heart surgery</topic><topic>Humans</topic><topic>Male</topic><topic>Medical equipment</topic><topic>Medical sciences</topic><topic>Middle Aged</topic><topic>Monitoring, Intraoperative - instrumentation</topic><topic>Monitoring, Intraoperative - methods</topic><topic>Monitoring, Physiologic - instrumentation</topic><topic>Monitoring, Physiologic - methods</topic><topic>Perioperative Care - instrumentation</topic><topic>Perioperative Care - methods</topic><topic>Pilot Projects</topic><topic>Postoperative Care - methods</topic><topic>Pulmonary Artery - physiopathology</topic><topic>Reproducibility of Results</topic><topic>Thermodilution - methods</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>van der Kleij, S. C. J.</creatorcontrib><creatorcontrib>Koolen, B. B.</creatorcontrib><creatorcontrib>Newhall, D. A.</creatorcontrib><creatorcontrib>Gerritse, B. M.</creatorcontrib><creatorcontrib>Rosseel, P. M. J.</creatorcontrib><creatorcontrib>Rijpstra, T. A.</creatorcontrib><creatorcontrib>Geisler, F. E. A.</creatorcontrib><creatorcontrib>van der Meer, N. J. 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M.</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Clinical evaluation of a new tracheal impedance cardiography method</atitle><jtitle>Anaesthesia</jtitle><addtitle>Anaesthesia</addtitle><date>2012-07</date><risdate>2012</risdate><volume>67</volume><issue>7</issue><spage>729</spage><epage>733</epage><pages>729-733</pages><issn>0003-2409</issn><eissn>1365-2044</eissn><coden>ANASAB</coden><abstract>Summary
Non‐invasive cardiac output measurement by means of impedance cardiography has been evaluated before, and agreement with other methods has been variable. We decided to study a newly developed tracheal impedance device, that is claimed to be more accurate and reliable. This incorporates new software and mathematical formulae, that are designed to reduce signal noise from diathermy, leading to improved accuracy. In 25 cardiothoracic surgery patients, simultaneous measurements were performed using both pulmonary artery thermodilution and the tracheal impedance device, at five peri‐operative time points: before skin incision; after weaning from cardiopulmonary bypass; after sternal closure; and 30 min and 2 h after arrival in the intensive care unit. Mean cardiac output, bias and 95% limits of agreement were 5.3, 0.03 and −2.8 to 2.8 l.min−1, respectively. Tracheal impedance showed good correlation with measurement trends using thermodilution in 88% of measurements, with a mean (95% limit of agreement) angular bias of −9.0° (−83.3 to 65.3°). However, the wide limits of agreement and high percentage error of 53% that were apparent in this study mean that, in its present guise, tracheal impedance is not an acceptable alternative to thermodilution in cardiac surgical patients.</abstract><cop>Oxford, UK</cop><pub>Blackwell Publishing Ltd</pub><pmid>22420758</pmid><doi>10.1111/j.1365-2044.2012.07089.x</doi><tpages>5</tpages><oa>free_for_read</oa></addata></record> |
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| subjects | Aged Anesthesia Anesthesia. Intensive care medicine. Transfusions. Cell therapy and gene therapy Biological and medical sciences Cardiac Output Cardiography, Impedance - instrumentation Cardiography, Impedance - methods Cardiopulmonary Bypass Coronary Artery Bypass Electrocardiography Female Heart surgery Humans Male Medical equipment Medical sciences Middle Aged Monitoring, Intraoperative - instrumentation Monitoring, Intraoperative - methods Monitoring, Physiologic - instrumentation Monitoring, Physiologic - methods Perioperative Care - instrumentation Perioperative Care - methods Pilot Projects Postoperative Care - methods Pulmonary Artery - physiopathology Reproducibility of Results Thermodilution - methods |
| title | Clinical evaluation of a new tracheal impedance cardiography method |
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