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Medicina crítica (Colegio Mexicano de Medicina Crítica)
versión impresa ISSN 2448-8909
Resumen
CUESTA TORRES, Julia et al. Comparison of cardiac output estimation by echocardiography, bioreactance and ultrasonic cardiac output monitor. Med. crít. (Col. Mex. Med. Crít.) [online]. 2019, vol.33, n.3, pp.116-120. Epub 15-Feb-2021. ISSN 2448-8909.
Cardiac output is the most frequent advanced monitoring in critical care units given its utility to guide resuscitation in septic shock. Echocardiography has been postulated has the gold standard for non-invasive cardiac output measurement, however this technique is operator-dependent and should be performed by an expert. Other techniques such as bioreactance and Doppler monitoring by semiautomatic USCOM system are 100% non-invasive techniques, also these measurements are not operator or expert dependent.
Objective:
To analyze the agreement of cardiac output by echocardiography vs Bioreactance and USCOM.
Material and methods:
Prospective observational study in which 26 patients diagnosed with septic shock admitted to the intensive care unit were cardiac output was measured by echocardiography, bioreactance and USCOM system. Bland Altman method was performed to analyze the agreement between the different techniques: echocardiography vs USCOM and echocardiography vs bioreactance. Also Linn coefficient was calculated in the same groups of measurements.
Results:
Bioreactance vs echocardiography reported a bias (mean of the differences) of -0.08 with a standard deviation (precision) of 0.85 and a 95% confidence interval of 1.59 to -1.75, finally an error of 24% and Linn coefficient of 0.78. USCOM vs echocardiography reported a bias (mean of the differences) of 1.11 with a standard deviation (precision) of 0.95 and a 95% confidence interval of 2.98 to -0.75, finally an error of 41% and Linn coefficient of 0.6.
Conclusions:
Bioreactance is a promising technique for cardiac output measurement given its good agreement with echocardiography, in the other hand USCOM did not showed a satisfactory agreement with echocardiography, more studies are needed to verify the clinical usefulness of these different techniques.
Palabras llave : Septic shock; cardiac output; hemodynamic monitoring.
