University of Oulu

Ylikauma, L. A., Lanning, K. M., Erkinaro, T. M., Ohtonen, P. P., Vakkala, M. A., Liisanantti, J. H., Juvonen, T. S., & Kaakinen, T. I. (2022). Reliability of bioreactance and pulse-power analysis in measuring cardiac index in patients undergoing cardiac surgery with cardiopulmonary bypass. Journal of Cardiothoracic and Vascular Anesthesia, 36(8), 2446–2453.

Reliability of bioreactance and pulse-power analysis in measuring cardiac index in patients undergoing cardiac surgery with cardiopulmonary bypass

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Author: Ylikauma, Laura Anneli1; Lanning, Katriina Marjatta1; Erkinaro, Tiina Maria1;
Organizations: 1Research Group of Surgery, Anesthesiology and Intensive Care Medicine, Medical Research Center Oulu, Oulu University Hospital and University of Oulu, Oulu, Finland
2Division of Operative Care, Oulu University Hospital, Oulu, Finland
3Department of Cardiac Surgery, Heart and Lung Center, Helsinki University Central Hospital, Helsinki University Hospital, Helsinki, Finland
Format: article
Version: accepted version
Access: open
Online Access: PDF Full Text (PDF, 1.8 MB)
Persistent link:
Language: English
Published: Elsevier, 2022
Publish Date: 2023-03-03


Objectives: Less-invasive and continuous cardiac output monitors recently have been developed to monitor patient hemodynamics. The aim of this study was to compare the accuracy, precision, and trending ability of noninvasive bioreactance-based Starling SV and miniinvasive pulse-power device LiDCOrapid to bolus thermodilution technique with a pulmonary artery catheter (TDCO) when measuring cardiac index in the setting of cardiac surgery with cardiopulmonary bypass (CPB).

Design: A prospective method-comparison study.

Setting: Oulu University Hospital, Finland.

Participants: Twenty patients undergoing cardiac surgery with CPB.

Interventions: Cardiac index measurements were obtained simultaneously with TDCO intraoperatively and postoperatively, resulting in 498 measurements with Starling SV and 444 with LiDCOrapid.

Measurements and Main Results: The authors used the Bland-Altman method to investigate the agreement between the devices and four-quadrant plots with error grids to assess the trending ability. The agreement between TDCO and Starling SV was qualified with a bias of 0.43 L/min/m² (95% confidence interval [CI], 0.37–0.50), wide limits of agreement (LOA, −1.07 to 1.94 L/min/m²), and a percentage error (PE) of 66.3%. The agreement between TDCO and LiDCOrapid was qualified, with a bias of 0.22 L/min/m² (95% CI 0.16–0.27), wide LOA (−0.93 to 1.43), and a PE of 53.2%. With both devices, trending ability was insufficient.

Conclusions: The reliability of bioreactance-based Starling SV and pulse-power analyzer LiDCOrapid was not interchangeable with TDCO, thus limiting their usefulness in cardiac surgery with CPB.

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Series: Journal of cardiothoracic and vascular anesthesia
ISSN: 1053-0770
ISSN-E: 1532-8422
ISSN-L: 1053-0770
Volume: 36
Issue: 8
Pages: 2446 - 2453
DOI: 10.1053/j.jvca.2021.11.039
Type of Publication: A1 Journal article – refereed
Field of Science: 3126 Surgery, anesthesiology, intensive care, radiology
Copyright information: © 2022. This manuscript version is made available under the CC-BY-NC-ND 4.0 license