Ультразвуковой мониторинг сердечного индекса после аортокоронарного шунтирования на работающем сердце

Н. Н. Изотова; Я. Ю. Ильина; Е. В. Фот; А. А. Сметкин; В. В. Кузьков; Михаил Юрьевич Киров

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

No. 2 (2018), MONITORING IN INTENSIVE CARE

No. 2 (2018)

MONITORING IN INTENSIVE CARE

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

Published 24.06.2018

N.N. Izotova⁺⁻
Y.Yu. Ilyina⁺⁻
E.V. Fot⁺⁻
A.A. Smetkin⁺⁻
V.V. Kuzkov⁺⁻
Mikhail Yu. Kirov⁺⁻

N.N. Izotova

Northern State Medical University, Arkhangelsk; Volosevich First City Clinical Hospital, Arkhangelsk

https://orcid.org/0000-0001-9274-7336

Y.Yu. Ilyina

Northern State Medical University, Arkhangelsk; Volosevich First City Clinical Hospital, Arkhangelsk

https://orcid.org/0000-0003-2538-4656

E.V. Fot

Northern State Medical University, Arkhangelsk; Volosevich First City Clinical Hospital, Arkhangelsk

https://orcid.org/0000-0003-0052-8086

A.A. Smetkin

Northern State Medical University, Arkhangelsk; Volosevich First City Clinical Hospital, Arkhangelsk

https://orcid.org/0000-0003-4133-4173

V.V. Kuzkov

Northern State Medical University, Arkhangelsk; Volosevich First City Clinical Hospital, Arkhangelsk

https://orcid.org/0000-0002-8191-1185

Mikhail Yu. Kirov

Northern State Medical University, Arkhangelsk; Volosevich First City Clinical Hospital, Arkhangelsk

https://orcid.org/0000-0002-4375-3374

PDF_2018-2_57-60 (Russian)

Keywords

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

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Izotova N.N., Ilyina Y.Y., Fot E.V., Smetkin A.A., Kuzkov V.V., Kirov M.Y. Ultrasound-based monitoring of cardiac output after off-pump coronary artery bypass grafting. Annals of Critical Care. 2018;(2):57-60. doi:10.21320/1818-474X-2018-2-57-60

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Abstract

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.

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References

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СметкинА.А., Хуссейн А., Фот Е.В., Изотова Н.Н. и др. Инвазивный мониторинг сердечного выброса по времени транзита пульсовой волны после аортокоронарного шунтирования на работающем сердце. Вестник анестезиологии и реаниматологии. 2016; 13(5): 4–10. [Smetkin A.A., Hussain A., Fot E.V., Izotova N.N., et al. Invasive monitoring of cardiac output by pulse wave transit time after aortocoronary bypass on the beating heart. Messenger of anesthesiology and resuscitation. 2016; 13(5): 4–10. (In Russ)].
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