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Master Thesis

Mesure du débit cardiaque par Vigileo, Most Care versus Swan-Ganz, en post opératoire de chirurgie cardiaque

Abstract : The reference technique for cardiac output (CO) monitoring is thermodilution with Swan-Ganz catheter. New techniques less invasive based on the arterial pulse contour analysis were developed: Vigileo and PRAM. The aim of this study was to compare the continuous cardiac output (CCO) measurements of these 2 techniques with Swan-Ganz continuous thermodilution in postoperative period of cardiac surgery. Nineteen patients were included. During 18 hours, CCO measurement by monitor Vigilance II and invasive blood pressure curve were recorded. Secondarily, this curve was injected in a pressure simulator and transmitted simultaneously in the cardiac flowmeter MostCare and Vigileo. The measures were compared to CCO Swan-Ganz measure every minute. 20% of the values further away from the mean value were removed. The methods of measure of CCO were compared by linear regression. Bland and Altman method was used to determine bias and limits of agreement. A percentage error, by Critchley test, less than 30% was chosen as equivalency criterion of the two methods. The coefficient of correlation between Vigileo and thermodilution was 0.89 (p < 0.001 IC 95% =[0.88; 0.90]), the mean difference was -0,9 L /min, and the limits of agreement were 1.3 L /min. The error percentage was good, 29%. The coefficient of correlation between MostCare and thermodilution was 0.7 (p < 0.001, IC 95%= [0.68; 0.73]), the mean difference was 0,9 L /min, and the limits of agreement were 1.6 L /min, the error percentage was 44,9%, so not sufficient.
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Master Thesis
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Camille Poquet. Mesure du débit cardiaque par Vigileo, Most Care versus Swan-Ganz, en post opératoire de chirurgie cardiaque. Médecine humaine et pathologie. 2014. ⟨dumas-01148170⟩

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