Paediatrics Publications
Impact of Obesity on Noninvasive Cardiac Hemodynamic Measurement by Electrical Cardiometry in Adults With Aortic Stenosis.
Document Type
Article
Publication Date
12-1-2018
Journal
Journal of Cardiothoracic and Vascular Anesthesia
Volume
32
Issue
6
First Page
2505
Last Page
2511
URL with Digital Object Identifier
https://doi.org/10.1053/j.jvca.2018.04.040
Abstract
Objectives
There are substantial potential benefits to noninvasive cardiac monitoring methods, such as electrical cardiometry (EC), over more invasive methods, including significantly reduced risk of complications, lower up-front and operational costs, ease of use, and continuous monitoring. To take advantage of these technologies, clinical equivalence to currently established methods must be determined. The authors sought to determine if the noninvasive measurement of cardiac index (CI) by EC was clinically equivalent to thermodilution (TD) in adult patients with aortic stenosis (AS).
Design
This is a cross-sectional study comparing measurement devices in a single patient group.
Setting
Single-center, university teaching hospital.
Participants
The study included 52 adult patients with aortic stenosis undergoing right heart catheterization.
Interventions
Cardiac output (CO) was measured concurrently using EC with an ICON device and TD in 52 participants with AS. CI values were to determine the accuracy and precision of EC in reference to TD. Percentage error (PE) was used to assess their clinical equivalence. The participants were divided further into groups (normal and overweight/obese) based on body mass index and the analysis was repeated.
Measurements and Main Results
CO measurement made by EC in adult patients with obesity or overweight was reduced significantly relative to TD. This was not observed in normal-weight adult AS patients. EC provided clinically equivalent measurements to TD for measuring CI in normal-weight adult AS patients (PE = 25.0%), but not for those adult AS patients with overweight or obesity (PE = 42.3%).
Conclusion
Overall, the ICON device produced lower CO and index measurements relative to TD in adult patients with AS. Overweight and obesity also significantly affected the relative precision and accuracy of the ICON electrical cardiometric device to measure CI in these patients.
Notes
Article originally published at Journal of Cardiothoracic and Vascular Anesthesia
https://doi.org/10.1053/j.jvca.2018.04.040