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Comparison of monitoring performance of bioreactance versus esophageal Doppler in pediatric patients.

Dubost C, Bouglé A, Hallynck C, Le Dorze M, Roulleau P, Baujard C, Benhamou D - Indian J Crit Care Med (2015)

Bottom Line: Continuously recorded hemodynamic variables obtained from both bioreactance and TED were compared.For children weighing >15 kg, results were: Bias 0.51 L/min/m(2), precision 1.17 L/min/m(2), limits of agreement -0.64 to 1.66 L/min/m(2) and percentage error 34%.Bioreactance cannot be considered suitable for monitoring pediatric patients.

View Article: PubMed Central - PubMed

Affiliation: Départment of Anesthésie-Réanimation, Hôpital Bicêtre, Le Kremlin-Bicêtre, France.

ABSTRACT

Background and aims: Cardiac output (CO) monitoring and goal-directed therapy during major abdominal surgery is currently used to decrease postoperative complications. However, few monitors are currently available for pediatric patients. Nicom(®) is a noninvasive CO monitoring technique based on the bioreactance principle (analysis of frequency variations of a delivered oscillating current traversing the thoracic cavity). Nicom(®) may be a useful monitor for pediatric patients.

Subjects and methods: Pediatric patients undergoing major abdominal surgery under general anesthesia with cardiac monitoring by transesophageal Doppler (TED) were included. Continuously recorded hemodynamic variables obtained from both bioreactance and TED were compared. Data were analyzed using the Bland-Altman method.

Results: A total of 113 pairs of cardiac index (CI) measurments from 16 patients were analyzed. Mean age was 59 months (95% CI: 42-75) and mean weight was 17 kg (95% CI: 15-20). In the overall population, Bland-Altman analysis revealed a bias of 0.4 L/min/m(2), precision of 1.55 L/min/m(2), limits of agreement of -1.1 to 1.9 L/min/m(2) and a percentage error of 47%. For children weighing >15 kg, results were: Bias 0.51 L/min/m(2), precision 1.17 L/min/m(2), limits of agreement -0.64 to 1.66 L/min/m(2) and percentage error 34%.

Conclusion: Simultaneous CI estimations made by bioreactance and TED showed high percentage of errors that is not clinically acceptable. Bioreactance cannot be considered suitable for monitoring pediatric patients.

No MeSH data available.


Related in: MedlinePlus

Bland–Altman analysis of stroke volume indexed between transesophageal Doppler and bioreactance in the global population
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Figure 4: Bland–Altman analysis of stroke volume indexed between transesophageal Doppler and bioreactance in the global population

Mentions: The Spearman's correlation coefficient between bioreactance and TED was 0.47 (P < 0.0001) [Figure 3]. The mean values of stroke SVI for bioreactance and TED were 27.54 and 27.32 mL/m2 respectively. Bland-Altman analysis revealed a bias of 0.22 mL/m2, precision of 22 mL/m2, limits of agreement of −21.79 to 21.35 mL/m2 and a percentage error of 81% [Figure 4]. The coefficients of variations for the bioreactance and the TED were 35% and 49%, respectively.


Comparison of monitoring performance of bioreactance versus esophageal Doppler in pediatric patients.

Dubost C, Bouglé A, Hallynck C, Le Dorze M, Roulleau P, Baujard C, Benhamou D - Indian J Crit Care Med (2015)

Bland–Altman analysis of stroke volume indexed between transesophageal Doppler and bioreactance in the global population
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC4296408&req=5

Figure 4: Bland–Altman analysis of stroke volume indexed between transesophageal Doppler and bioreactance in the global population
Mentions: The Spearman's correlation coefficient between bioreactance and TED was 0.47 (P < 0.0001) [Figure 3]. The mean values of stroke SVI for bioreactance and TED were 27.54 and 27.32 mL/m2 respectively. Bland-Altman analysis revealed a bias of 0.22 mL/m2, precision of 22 mL/m2, limits of agreement of −21.79 to 21.35 mL/m2 and a percentage error of 81% [Figure 4]. The coefficients of variations for the bioreactance and the TED were 35% and 49%, respectively.

Bottom Line: Continuously recorded hemodynamic variables obtained from both bioreactance and TED were compared.For children weighing >15 kg, results were: Bias 0.51 L/min/m(2), precision 1.17 L/min/m(2), limits of agreement -0.64 to 1.66 L/min/m(2) and percentage error 34%.Bioreactance cannot be considered suitable for monitoring pediatric patients.

View Article: PubMed Central - PubMed

Affiliation: Départment of Anesthésie-Réanimation, Hôpital Bicêtre, Le Kremlin-Bicêtre, France.

ABSTRACT

Background and aims: Cardiac output (CO) monitoring and goal-directed therapy during major abdominal surgery is currently used to decrease postoperative complications. However, few monitors are currently available for pediatric patients. Nicom(®) is a noninvasive CO monitoring technique based on the bioreactance principle (analysis of frequency variations of a delivered oscillating current traversing the thoracic cavity). Nicom(®) may be a useful monitor for pediatric patients.

Subjects and methods: Pediatric patients undergoing major abdominal surgery under general anesthesia with cardiac monitoring by transesophageal Doppler (TED) were included. Continuously recorded hemodynamic variables obtained from both bioreactance and TED were compared. Data were analyzed using the Bland-Altman method.

Results: A total of 113 pairs of cardiac index (CI) measurments from 16 patients were analyzed. Mean age was 59 months (95% CI: 42-75) and mean weight was 17 kg (95% CI: 15-20). In the overall population, Bland-Altman analysis revealed a bias of 0.4 L/min/m(2), precision of 1.55 L/min/m(2), limits of agreement of -1.1 to 1.9 L/min/m(2) and a percentage error of 47%. For children weighing >15 kg, results were: Bias 0.51 L/min/m(2), precision 1.17 L/min/m(2), limits of agreement -0.64 to 1.66 L/min/m(2) and percentage error 34%.

Conclusion: Simultaneous CI estimations made by bioreactance and TED showed high percentage of errors that is not clinically acceptable. Bioreactance cannot be considered suitable for monitoring pediatric patients.

No MeSH data available.


Related in: MedlinePlus