Comparison the accuracy and trending ability of cardiac index measured by the fourthgeneration of FloTrac with the PiCCO device in septic shock patients

Abstract

Background/aim: FloTrac/Vigileo is a noncalibrated arterial pressure waveform analysis for cardiac index (CI) monitoring. The aim ofour study was to compare the CI measured by the 4th generation of FloTrac with PiCCO in septic shock patients.Materials and methods: We simultaneously measured the CI using FloTrac (CIv) and compared it with the CI derived fromtranspulmonary thermodilution (CItd) as well as the pulse contour-derived CI using PiCCO (CIp).Results: Thirty-one septic shock patients were included. The CIv correlated with CItd (r = 0.62, P < 0.0001). The Bland-Altman analysisshowed a bias of 0.14, and the limits of agreement were –1.62–1.91 L/min/m2 with a percentage error of 47.4%. However, the concordancerate between CIv and CItd was 93.6%. The comparison of CIv with CIp (n = 352 paired measurements) revealed a bias of -0.16, and thelimits of agreement were –1.45–1.79 L/min/m2 with a percentage error of 44.8%. The overall correlation coefficient between CIv and CIpwas 0.63 (P < 0.0001), and the concordance rate was 85.4%.Conclusion: The 4th generation of FloTrac has not acceptable agreement to assess CI; however, it has the ability to tracked changes ofCI, when compared with the transpulmonary thermodilution method by PiCCO.