Ultrasound-based monitoring of cardiac output after off-pump coronary artery bypass grafting


N.N. Izotova1, 2, Y.Yu. Ilyina1, 2, E.V. Fot1, 2, A.A. Smetkin1, 2, V.V. Kuzkov1, 2, M.Yu. Kirov1, 2

Northern State Medical University, Arkhangelsk

2 Volosevich First City Clinical Hospital, Arkhangelsk

For correspondence: Kirov Mikhail Yu. — MD, PhD, professor, Head of the Department of Anesthesiology and Intensive care of Northern State Medical University, Arkhangelsk; e-mail: mikhail_kirov@hotmail.com

For citation: Izotova NN, Il’ina YaYu, Fot EV, et al. Ultrasound-based monitoring of cardiac output after off-pump coronary artery bypass grafting. Alexander Saltanov Intensive Care Herald. 2018;2:57–60.

DOI: 10.21320/1818-474X-2018-2-57-60

Aim of the study. To assess the accuracy of USCOM in patients after off-pump coronary artery bypass grafting (OPCAB).

Methods. We enrolled 14 patients who underwent elective OPCAB into an ongoing prospective observational study. The measurements of cardiac index (CI) based on USCOM (CIUSCOM) in comparison with thermodilution CI (CITD) were performed at seven stages during postoperative period. Statistical analysis included assessment of agreement in absolute values of CI using Bland–Altman analysis.

Results. Totally, 98 pairs of data were collected. According to Bland–Altman analysis of all pairs of data, mean bias between CIUSCOM and CITD was –1.09 L/min/m2 with limits of agreement of ±1.18 L/min/m2 and percentage error of 63 %. In a subgroup of stages with requirement of mechanical ventilation the intermethod bias was –1.16 L/min/m2 with limits of agreement of ±1.15 L/min/m2 and percentage error of 67 %, in a subgroup of stages after tracheal extubation the mean bias was –1.00 L/min/m2 with limits of agreement of ±1.23 L/min/m2 and percentage error of 59 %.

Conclusions. USCOM demonstrates poor accuracy with underestimation of CI compared to thermodilution technique both before and after tracheal extubation. This method can not be recommended as an acceptable alternative in cardiac surgery.

Keywords: cardiac index, hemodynamics, monitoring of hemodynamics, off-pump coronary artery bypass grafting

Received: 31.03.2018

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