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Schneck E, Drubel P, Schürg R, Markmann M, Kohl T, Henrich M, Sander M, Koch C. Evaluation of pulse wave transit time analysis for non-invasive cardiac output quantification in pregnant patients. Sci Rep 2020; 10:1857. [PMID: 32024981 PMCID: PMC7002624 DOI: 10.1038/s41598-020-58910-x] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/16/2019] [Accepted: 01/22/2020] [Indexed: 01/09/2023] Open
Abstract
Pregnant patients undergoing minimally-invasive foetoscopic surgery for foetal spina bifida have a need to be subjected to advanced haemodynamic monitoring. This observational study compares cardiac output as measured by transpulmonary thermodilution monitoring with the results of non-invasive estimated continuous cardiac output monitoring. Transpulmonary thermodilution-based pulse contour analysis was performed for usual anaesthetic care, while non-invasive estimated continuous cardiac output monitoring data were additionally recorded. Thirty-five patients were enrolled, resulting in 199 measurement time points. Cardiac output measurements of the non-invasive estimated continuous cardiac output monitoring showed a weak correlation with the corresponding thermodilution measurements (correlation coefficient: 0.44, R2: 0.19; non-invasive estimated continuous cardiac output: 7.4 [6.2-8.1]; thermodilution cardiac output: 8.9 [7.8-9.8]; p ≤ 0.001), while cardiac index experienced no such correlation. Furthermore, neither stroke volume nor stroke volume index correlated with the corresponding thermodilution-based data. Even though non-invasive estimated continuous cardiac output monitoring consistently underestimated the corresponding thermodilution parameters, no trend analysis was achievable. Summarizing, we cannot suggest the use of non-invasive estimated continuous cardiac output monitoring as an alternative to transpulmonary thermodilution for cardiac output monitoring in pregnant patients undergoing minimally-invasive foetoscopic surgery for spina bifida.
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Affiliation(s)
- Emmanuel Schneck
- Justus Liebig University of Giessen, Department of Anesthesiology, Operative Intensive Care Medicine and Pain Therapy, Rudolf-Buchheim-Strasse 7, 35392, Giessen, Germany.
| | - Pascal Drubel
- Justus Liebig University of Giessen, Department of Anesthesiology, Operative Intensive Care Medicine and Pain Therapy, Rudolf-Buchheim-Strasse 7, 35392, Giessen, Germany
| | - Rainer Schürg
- Justus Liebig University of Giessen, Department of Anesthesiology, Operative Intensive Care Medicine and Pain Therapy, Rudolf-Buchheim-Strasse 7, 35392, Giessen, Germany
| | - Melanie Markmann
- Justus Liebig University of Giessen, Department of Anesthesiology, Operative Intensive Care Medicine and Pain Therapy, Rudolf-Buchheim-Strasse 7, 35392, Giessen, Germany
| | - Thomas Kohl
- German Center for Fetal Surgery & Minimally Invasive Therapy (DZFT), University Hospital of Mannheim, Theodor-Kutzer-Ufer 1-3, 68167, Mannheim, Germany
| | - Michael Henrich
- Department of Anesthesiology and Intensive Care Medicine, St. Vincentius Clinics, Suedendstrasse 32, 76137, Karlsruhe, Germany
| | - Michael Sander
- Justus Liebig University of Giessen, Department of Anesthesiology, Operative Intensive Care Medicine and Pain Therapy, Rudolf-Buchheim-Strasse 7, 35392, Giessen, Germany
| | - Christian Koch
- Justus Liebig University of Giessen, Department of Anesthesiology, Operative Intensive Care Medicine and Pain Therapy, Rudolf-Buchheim-Strasse 7, 35392, Giessen, Germany
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