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Unreliable Tracking Ability of the Third-Generation FloTrac/Vigileo™ System for Changes in Stroke Volume after Fluid Administration in Patients with High Systemic Vascular Resistance during Laparoscopic Surgery.

Chin JH, Kim WJ, Choi JH, Han YA, Kim SO, Choi WJ - PLoS ONE (2015)

Bottom Line: The FloTrac/Vigileo™ system does not thoroughly reflect variable arterial tones, due to a lack of external calibration.The SV-Vigileo was significantly higher than the SV-TEE both before (68.8 ± 15.9 vs. 57.0 ± 11.0 ml, P < 0.001) and after (73.0 ± 14.8 vs. 64.9 ± 12.2 ml, P = 0.003) fluid administration.Four-quadrant plot (69.2% of a concordance rate) and polar plot analysis (20.6° of a mean polar angle, 16.4° of the SD of a polar angle, and ±51.5° of a radial sector containing 95% of the data points) did not indicate a good trending ability of the FloTrac/Vigileo™ system.

View Article: PubMed Central - PubMed

Affiliation: Department of Anesthesiology and Pain Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea.

ABSTRACT

Background: The FloTrac/Vigileo™ system does not thoroughly reflect variable arterial tones, due to a lack of external calibration. The ability of this system to measure stroke volume and track its changes after fluid administration has not been fully evaluated in patients with the high systemic vascular resistance that can develop during laparoscopic surgery.

Methods: In 42 patients undergoing laparoscopic prostatectomy, the stroke volume derived by the third-generation FloTrac/Vigileo™ system (SV-Vigileo), the stroke volume measured using transesophageal echocardiography (SV-TEE) as a reference method, and total systemic vascular resistance were evaluated before and after 500 ml fluid administration during pneumoperitoneum combined with the Trendelenburg position.

Results: Total systemic vascular resistance was 2159.4 ± 523.5 dyn·s/cm5 before fluid administration. The SV-Vigileo was significantly higher than the SV-TEE both before (68.8 ± 15.9 vs. 57.0 ± 11.0 ml, P < 0.001) and after (73.0 ± 14.8 vs. 64.9 ± 12.2 ml, P = 0.003) fluid administration. During pneumoperitoneum combined with the Trendelenburg position, Bland-Altman analysis for repeated measures showed a 53.8% of percentage error between the SV-Vigileo and the SV-TEE. Four-quadrant plot (69.2% of a concordance rate) and polar plot analysis (20.6° of a mean polar angle, 16.4° of the SD of a polar angle, and ±51.5° of a radial sector containing 95% of the data points) did not indicate a good trending ability of the FloTrac/Vigileo™ system.

Conclusions: The third-generation FloTrac/Vigileo™ system may not be useful in patients undergoing laparoscopic surgery, based on unreliable performance in measuring the stroke volume and in tracking changes in the stroke volume after fluid administration during pneumoperitoneum combined with the Trendelenburg position.

No MeSH data available.


Related in: MedlinePlus

Correlation analyses(A) between total systemic vascular resistance (TSVR) and the differences between the stroke volumes measured using transesophageal echocardiography (SV-TEE) and the third-generation FloTrac/Vigileo™ system (SV-Vigileo) and (B) between arterial compliance the differences between the SV-TEE and the SV-Vigileo.
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pone.0142125.g003: Correlation analyses(A) between total systemic vascular resistance (TSVR) and the differences between the stroke volumes measured using transesophageal echocardiography (SV-TEE) and the third-generation FloTrac/Vigileo™ system (SV-Vigileo) and (B) between arterial compliance the differences between the SV-TEE and the SV-Vigileo.

Mentions: There was a significant correlation between arterial load (TSVR and arterial compliance) and the difference between the SV-TEE and the SV-Vigileo (Fig 3). The difference between the SV-TEE and the SV-Vigileo decreased with increasing TSVR (CC = -0.60, P < 0.001), and decreased with decreasing arterial compliance (CC = 0.60, P < 0.001).


Unreliable Tracking Ability of the Third-Generation FloTrac/Vigileo™ System for Changes in Stroke Volume after Fluid Administration in Patients with High Systemic Vascular Resistance during Laparoscopic Surgery.

Chin JH, Kim WJ, Choi JH, Han YA, Kim SO, Choi WJ - PLoS ONE (2015)

Correlation analyses(A) between total systemic vascular resistance (TSVR) and the differences between the stroke volumes measured using transesophageal echocardiography (SV-TEE) and the third-generation FloTrac/Vigileo™ system (SV-Vigileo) and (B) between arterial compliance the differences between the SV-TEE and the SV-Vigileo.
© Copyright Policy
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC4631474&req=5

pone.0142125.g003: Correlation analyses(A) between total systemic vascular resistance (TSVR) and the differences between the stroke volumes measured using transesophageal echocardiography (SV-TEE) and the third-generation FloTrac/Vigileo™ system (SV-Vigileo) and (B) between arterial compliance the differences between the SV-TEE and the SV-Vigileo.
Mentions: There was a significant correlation between arterial load (TSVR and arterial compliance) and the difference between the SV-TEE and the SV-Vigileo (Fig 3). The difference between the SV-TEE and the SV-Vigileo decreased with increasing TSVR (CC = -0.60, P < 0.001), and decreased with decreasing arterial compliance (CC = 0.60, P < 0.001).

Bottom Line: The FloTrac/Vigileo™ system does not thoroughly reflect variable arterial tones, due to a lack of external calibration.The SV-Vigileo was significantly higher than the SV-TEE both before (68.8 ± 15.9 vs. 57.0 ± 11.0 ml, P < 0.001) and after (73.0 ± 14.8 vs. 64.9 ± 12.2 ml, P = 0.003) fluid administration.Four-quadrant plot (69.2% of a concordance rate) and polar plot analysis (20.6° of a mean polar angle, 16.4° of the SD of a polar angle, and ±51.5° of a radial sector containing 95% of the data points) did not indicate a good trending ability of the FloTrac/Vigileo™ system.

View Article: PubMed Central - PubMed

Affiliation: Department of Anesthesiology and Pain Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea.

ABSTRACT

Background: The FloTrac/Vigileo™ system does not thoroughly reflect variable arterial tones, due to a lack of external calibration. The ability of this system to measure stroke volume and track its changes after fluid administration has not been fully evaluated in patients with the high systemic vascular resistance that can develop during laparoscopic surgery.

Methods: In 42 patients undergoing laparoscopic prostatectomy, the stroke volume derived by the third-generation FloTrac/Vigileo™ system (SV-Vigileo), the stroke volume measured using transesophageal echocardiography (SV-TEE) as a reference method, and total systemic vascular resistance were evaluated before and after 500 ml fluid administration during pneumoperitoneum combined with the Trendelenburg position.

Results: Total systemic vascular resistance was 2159.4 ± 523.5 dyn·s/cm5 before fluid administration. The SV-Vigileo was significantly higher than the SV-TEE both before (68.8 ± 15.9 vs. 57.0 ± 11.0 ml, P < 0.001) and after (73.0 ± 14.8 vs. 64.9 ± 12.2 ml, P = 0.003) fluid administration. During pneumoperitoneum combined with the Trendelenburg position, Bland-Altman analysis for repeated measures showed a 53.8% of percentage error between the SV-Vigileo and the SV-TEE. Four-quadrant plot (69.2% of a concordance rate) and polar plot analysis (20.6° of a mean polar angle, 16.4° of the SD of a polar angle, and ±51.5° of a radial sector containing 95% of the data points) did not indicate a good trending ability of the FloTrac/Vigileo™ system.

Conclusions: The third-generation FloTrac/Vigileo™ system may not be useful in patients undergoing laparoscopic surgery, based on unreliable performance in measuring the stroke volume and in tracking changes in the stroke volume after fluid administration during pneumoperitoneum combined with the Trendelenburg position.

No MeSH data available.


Related in: MedlinePlus