Ylikauma, L.A., Tuovila, M.J., Ohtonen, P.P. et al. Reliability of bioreactance and pulse power analysis in measuring cardiac index during cytoreductive abdominal surgery with hyperthermic intraperitoneal chemotherapy (HIPEC). BMC Anesthesiol 23, 38 (2023). https://doi.org/10.1186/s12871-023-01988-3
Reliability of bioreactance and pulse power analysis in measuring cardiac index during cytoreductive abdominal surgery with hyperthermic intraperitoneal chemotherapy (HIPEC)
|Author:||Ylikauma, Laura Anneli1; Tuovila, Mari Johanna1; Ohtonen, Pasi Petteri1,2;|
1Research Group of Surgery, Intensive Care Unit, Anaesthesiology and Intensive Care Medicine, Medical Research Center Oulu, Oulu University Hospital and University of Oulu, PL 21, 90029 OYS, Oulu, Finland
2Research Service Unit, Oulu University Hospital, Oulu, Finland
3Department of Surgery, Oulu University Hospital, Oulu, Finland
|Online Access:||PDF Full Text (PDF, 0.9 MB)|
|Persistent link:|| http://urn.fi/urn:nbn:fi-fe2023081094656
|Publish Date:|| 2023-08-10
Purpose: Various malignancies with peritoneal carcinomatosis are treated with cytoreductive surgery and hyperthermic intraperitoneal chemotherapy (HIPEC). The hemodynamic instability resulting from fluid balance alterations during the procedure necessitates reliable hemodynamic monitoring. The aim of the study was to compare the accuracy, precision and trending ability of two less invasive hemodynamic monitors, bioreactance-based Starling SV and pulse power device LiDCOrapid with bolus thermodilution technique with pulmonary artery catheter in the setting of cytoreductive surgery with HIPEC.
Methods: Thirty-one patients scheduled for cytoreductive surgery were recruited. Twenty-three of them proceeded to HIPEC and were included to the study. Altogether 439 and 430 intraoperative bolus thermodilution injections were compared to simultaneous cardiac index readings obtained with Starling SV and LiDCOrapid, respectively. Bland-Altman method, four-quadrant plots and error grids were used to assess the agreement of the devices.
Results: Comparing Starling SV with bolus thermodilution, the bias was acceptable (0.13 l min⁻¹ m⁻², 95% CI 0.05 to 0.20), but the limits of agreement were wide (− 1.55 to 1.71 l min⁻¹ m⁻²) and the percentage error was high (60.0%). Comparing LiDCOrapid with bolus thermodilution, the bias was acceptable (− 0.26 l min⁻¹ m⁻², 95% CI − 0.34 to − 0.18), but the limits of agreement were wide (− 1.99 to 1.39 l min⁻¹ m⁻²) and the percentage error was high (57.1%). Trending ability was inadequate with both devices.
Conclusion: Starling SV and LiDCOrapid were not interchangeable with bolus thermodilution technique limiting their usefulness in the setting of cytoreductive surgery with HIPEC.
|Type of Publication:||
A1 Journal article – refereed
|Field of Science:||
3126 Surgery, anesthesiology, intensive care, radiology
Financial support was provided from the sources of Oulu University Hospital.
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