Evidence based performance
Performance favorably comparable to the gold standard
In 2009, a multi center study involving 7 facilities verified the effectiveness of esCCO as a practical application1). The figure below is one of data from the multi center study, which shows postoperative changes in cardiac output of a liver transplantation patient in the ICU. It shows a good agreement between intermittent thermodilution derived CO, continuous thermodilution derived CO, and esCCO in the ICU.
esCCO and CCO in liver transplantation
Comparison of esCCO, ICO, CCO in ICU post liver transplantation. Postoperative change in cardiac output of a liver transplantation patient in intensive care unit (ICU). Cirrhosis is accompanied by various cardiovascular abnormalities which increase cardiac output (CO) and decrease arterial blood pressure and vascular resistance2). Therefore, perioperative monitoring of these parameters is extremely important for liver transplantation patients. This graph shows trend of esCCO observed in ICU after liver transplantation.
The cardiac output by cold bolus thermodilution (ICO) is given by red triangle. The esCCO, which was once calibrated by ICO on ICU admission, was in excellent agreement with ICO and CCO (brown line) measured by pulmonary artery catheter. Despite the underestimation of CO due to decreased vascular resistance, esCCO calibrated with patient information (gold line) shows an equivalent trend to CCO. These results indicate that esCCO has a promising performance for tracking change in CO after removal of pulmonary artery catheter.
1) Yamada T, Tsutsui M, Sugo Y, Sato T, Akazawa T, Sato N, Yamashita K, Ishihara H, Takeda J. Multicenter Study Verifying a Method of Noninvasive Continuous Cardiac Output Measurement Using Pulse Wave Transit Time: A Comparison with Intermittent Bolus Thermodilution Cardiac Output. Anesth Analg. 2012 Mar 30
2) Ralph F. Lee. Cardiac dysfunction in cirrhosis. Best Practice & Research Clinical Gastroenterology, Vol. 21, No. 1, pp. 125e140, 2007.
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