Comparison of noninvasive electrical cardiometry and transpulmonary thermodilution for cardiac output measurement in critically ill patients: a prospective observational study
Abstract Background Cardiac output (CO) monitoring is essential for diagnosing and managing critically ill patients. Recently, a non-invasive haemodynamic monitoring technique, electrical cardiometry (EC), has gathered increasing interest among ICU physicians. This study aimed to explore the accurac...
Saved in:
| Main Authors: | , , , , , , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
BMC
2025-03-01
|
| Series: | BMC Anesthesiology |
| Subjects: | |
| Online Access: | https://doi.org/10.1186/s12871-025-03005-1 |
| Tags: |
Add Tag
No Tags, Be the first to tag this record!
|
| _version_ | 1849773848217518080 |
|---|---|
| author | Wenliang Song Jiayan Guo Daiyin Cao Jinlong Jiang Tao Yang Xiaoxun Ma Hao Yuan Jianfeng Wu Xiangdong Guan Xiang Si |
| author_facet | Wenliang Song Jiayan Guo Daiyin Cao Jinlong Jiang Tao Yang Xiaoxun Ma Hao Yuan Jianfeng Wu Xiangdong Guan Xiang Si |
| author_sort | Wenliang Song |
| collection | DOAJ |
| description | Abstract Background Cardiac output (CO) monitoring is essential for diagnosing and managing critically ill patients. Recently, a non-invasive haemodynamic monitoring technique, electrical cardiometry (EC), has gathered increasing interest among ICU physicians. This study aimed to explore the accuracy of CO estimated by non-invasive EC (COEC) compared to CO determined by transpulmonary thermodilution (COTPTD) and to evaluate the ability of COEC to track COTPTD changes (ΔCOTPTD). Methods This prospective, observational, single-center study was conducted from April 2021 to April 2023, involving patients who required haemodynamic monitoring using a transpulmonary thermodilution device (PiCCO). COTPTD and COEC were recorded simultaneously, with the investigators obtaining the COEC measurements were blinded to the COTPTD results and vice versa. Agreement between the methods was evaluated using Bland–Altman analysis and percentage error (PE). The ability of COEC to track changes in COTPTD was examined using four-quadrant and polar plots. Results Seventy-two patients with PiCCO haemodynamic monitoring were included, yielding 285 paired CO measurements. The bias between COEC and COTPTD was 0.47 L/min, with a limit of agreement (LoA) ranging from -2.91 to 3.85 L/min and a PE of 54.0%. Among 212 pairs of ΔCO data, excluding a central zone of 15% in the four-quadrant plot, the concordance rate between ΔCOEC % and ΔCOTPTD % was 70%. In the polar plot, excluding a central zone with a radius of 0.625 L/min (10% of the mean COTPTD), the mean polar angle for ΔCOEC was 2.2°, with a radial LoA of 56.0°. Exploratory subgroup analysis indicated a PE of 47.0% between COEC and COTPTD and a concordance rate of 72% between ΔCOEC% and ΔCOTPTD% in patients with normal CO (CO ≥ 4 L/min). In patients with elevated thoracic fluid content (TFC > 35 kΩ), the PE between COEC and COTPTD was 45.0%, with a concordance rate of 64% between ΔCOEC% and ΔCOTPTD%. Additionally, in patients receiving low-dose norepinephrine equivalents (NEE ≤ 0.25 μg/kg/min), COEC and COTPTD exhibited a PE of 45.0%, while ΔCOEC% and ΔCOTPTD% achieved a concordance rate of 75% and a radial LoA of 44.2°. Conclusion In critically ill patients, non-invasive EC indicated limited accuracy in measuring CO, along with a restricted ability to reliably track CO changes. These findings suggested that EC may not be interchangeable with TPTD in the general ICU population. |
| format | Article |
| id | doaj-art-a8ed0ea110024c7aa794f50c033f182c |
| institution | DOAJ |
| issn | 1471-2253 |
| language | English |
| publishDate | 2025-03-01 |
| publisher | BMC |
| record_format | Article |
| series | BMC Anesthesiology |
| spelling | doaj-art-a8ed0ea110024c7aa794f50c033f182c2025-08-20T03:01:55ZengBMCBMC Anesthesiology1471-22532025-03-012511910.1186/s12871-025-03005-1Comparison of noninvasive electrical cardiometry and transpulmonary thermodilution for cardiac output measurement in critically ill patients: a prospective observational studyWenliang Song0Jiayan Guo1Daiyin Cao2Jinlong Jiang3Tao Yang4Xiaoxun Ma5Hao Yuan6Jianfeng Wu7Xiangdong Guan8Xiang Si9Department of Critical Care Medicine, The First Affiliated Hospital of Sun Yat-Sen UniversityDepartment of Anesthesiology, Guangzhou Women and Children’s Medical CenterDepartment of Critical Care Medicine, The Sixth Affiliated Hospital of Sun Yat-Sen UniversityDepartment of Critical Care Medicine, The First Affiliated Hospital of Sun Yat-Sen UniversityDepartment of Critical Care Medicine, The First Affiliated Hospital of Sun Yat-Sen UniversityDepartment of Critical Care Medicine, The First Affiliated Hospital of Sun Yat-Sen UniversityDepartment of Critical Care Medicine, The First Affiliated Hospital of Sun Yat-Sen UniversityDepartment of Critical Care Medicine, The First Affiliated Hospital of Sun Yat-Sen UniversityDepartment of Critical Care Medicine, The First Affiliated Hospital of Sun Yat-Sen UniversityDepartment of Critical Care Medicine, The First Affiliated Hospital of Sun Yat-Sen UniversityAbstract Background Cardiac output (CO) monitoring is essential for diagnosing and managing critically ill patients. Recently, a non-invasive haemodynamic monitoring technique, electrical cardiometry (EC), has gathered increasing interest among ICU physicians. This study aimed to explore the accuracy of CO estimated by non-invasive EC (COEC) compared to CO determined by transpulmonary thermodilution (COTPTD) and to evaluate the ability of COEC to track COTPTD changes (ΔCOTPTD). Methods This prospective, observational, single-center study was conducted from April 2021 to April 2023, involving patients who required haemodynamic monitoring using a transpulmonary thermodilution device (PiCCO). COTPTD and COEC were recorded simultaneously, with the investigators obtaining the COEC measurements were blinded to the COTPTD results and vice versa. Agreement between the methods was evaluated using Bland–Altman analysis and percentage error (PE). The ability of COEC to track changes in COTPTD was examined using four-quadrant and polar plots. Results Seventy-two patients with PiCCO haemodynamic monitoring were included, yielding 285 paired CO measurements. The bias between COEC and COTPTD was 0.47 L/min, with a limit of agreement (LoA) ranging from -2.91 to 3.85 L/min and a PE of 54.0%. Among 212 pairs of ΔCO data, excluding a central zone of 15% in the four-quadrant plot, the concordance rate between ΔCOEC % and ΔCOTPTD % was 70%. In the polar plot, excluding a central zone with a radius of 0.625 L/min (10% of the mean COTPTD), the mean polar angle for ΔCOEC was 2.2°, with a radial LoA of 56.0°. Exploratory subgroup analysis indicated a PE of 47.0% between COEC and COTPTD and a concordance rate of 72% between ΔCOEC% and ΔCOTPTD% in patients with normal CO (CO ≥ 4 L/min). In patients with elevated thoracic fluid content (TFC > 35 kΩ), the PE between COEC and COTPTD was 45.0%, with a concordance rate of 64% between ΔCOEC% and ΔCOTPTD%. Additionally, in patients receiving low-dose norepinephrine equivalents (NEE ≤ 0.25 μg/kg/min), COEC and COTPTD exhibited a PE of 45.0%, while ΔCOEC% and ΔCOTPTD% achieved a concordance rate of 75% and a radial LoA of 44.2°. Conclusion In critically ill patients, non-invasive EC indicated limited accuracy in measuring CO, along with a restricted ability to reliably track CO changes. These findings suggested that EC may not be interchangeable with TPTD in the general ICU population.https://doi.org/10.1186/s12871-025-03005-1NoninvasiveThoracic fluid contentExtravascular lung waterMetrology, stroke volumeHaemodynamic |
| spellingShingle | Wenliang Song Jiayan Guo Daiyin Cao Jinlong Jiang Tao Yang Xiaoxun Ma Hao Yuan Jianfeng Wu Xiangdong Guan Xiang Si Comparison of noninvasive electrical cardiometry and transpulmonary thermodilution for cardiac output measurement in critically ill patients: a prospective observational study BMC Anesthesiology Noninvasive Thoracic fluid content Extravascular lung water Metrology, stroke volume Haemodynamic |
| title | Comparison of noninvasive electrical cardiometry and transpulmonary thermodilution for cardiac output measurement in critically ill patients: a prospective observational study |
| title_full | Comparison of noninvasive electrical cardiometry and transpulmonary thermodilution for cardiac output measurement in critically ill patients: a prospective observational study |
| title_fullStr | Comparison of noninvasive electrical cardiometry and transpulmonary thermodilution for cardiac output measurement in critically ill patients: a prospective observational study |
| title_full_unstemmed | Comparison of noninvasive electrical cardiometry and transpulmonary thermodilution for cardiac output measurement in critically ill patients: a prospective observational study |
| title_short | Comparison of noninvasive electrical cardiometry and transpulmonary thermodilution for cardiac output measurement in critically ill patients: a prospective observational study |
| title_sort | comparison of noninvasive electrical cardiometry and transpulmonary thermodilution for cardiac output measurement in critically ill patients a prospective observational study |
| topic | Noninvasive Thoracic fluid content Extravascular lung water Metrology, stroke volume Haemodynamic |
| url | https://doi.org/10.1186/s12871-025-03005-1 |
| work_keys_str_mv | AT wenliangsong comparisonofnoninvasiveelectricalcardiometryandtranspulmonarythermodilutionforcardiacoutputmeasurementincriticallyillpatientsaprospectiveobservationalstudy AT jiayanguo comparisonofnoninvasiveelectricalcardiometryandtranspulmonarythermodilutionforcardiacoutputmeasurementincriticallyillpatientsaprospectiveobservationalstudy AT daiyincao comparisonofnoninvasiveelectricalcardiometryandtranspulmonarythermodilutionforcardiacoutputmeasurementincriticallyillpatientsaprospectiveobservationalstudy AT jinlongjiang comparisonofnoninvasiveelectricalcardiometryandtranspulmonarythermodilutionforcardiacoutputmeasurementincriticallyillpatientsaprospectiveobservationalstudy AT taoyang comparisonofnoninvasiveelectricalcardiometryandtranspulmonarythermodilutionforcardiacoutputmeasurementincriticallyillpatientsaprospectiveobservationalstudy AT xiaoxunma comparisonofnoninvasiveelectricalcardiometryandtranspulmonarythermodilutionforcardiacoutputmeasurementincriticallyillpatientsaprospectiveobservationalstudy AT haoyuan comparisonofnoninvasiveelectricalcardiometryandtranspulmonarythermodilutionforcardiacoutputmeasurementincriticallyillpatientsaprospectiveobservationalstudy AT jianfengwu comparisonofnoninvasiveelectricalcardiometryandtranspulmonarythermodilutionforcardiacoutputmeasurementincriticallyillpatientsaprospectiveobservationalstudy AT xiangdongguan comparisonofnoninvasiveelectricalcardiometryandtranspulmonarythermodilutionforcardiacoutputmeasurementincriticallyillpatientsaprospectiveobservationalstudy AT xiangsi comparisonofnoninvasiveelectricalcardiometryandtranspulmonarythermodilutionforcardiacoutputmeasurementincriticallyillpatientsaprospectiveobservationalstudy |