Oscillating Continuous Cardiac Output in Postoperative Critically Ill Patients: Is this Phenomenon Accurate, Artifact, or Error?

Abstract Background: To compare safety and clinical efficacy of artificial intelligence (AI)-powered ultrasound with pulse index continuous cardiac output (PiCCO) for monitoring critically ill patients.Methods: Patients who were admitted to our hospital from April to June 2020 were recruited. PiCCO was employed to monitor cardiac output (CO) and extravascular lung water index (ELWI). Simultaneously, an AI-powered ultrasound was used to automatically monitor CO and the left ventricular outflow tract velocity time integral (LVOT-VTI), and Lung ultrasound B line.Results: A total of 41 patients were enrolled, the male/female ratio was 26:15, and the patients’ median age was 73.6±8.85 years old. There was no significant difference between PiCCO and AI-powered ultrasound in monitoring of CO (t = 1.01, P = 0.316), and the correlation between these two techniques was significant (r=0.911; 95% confidence interval (CI): [0.82; 0.96]; P < 0.001). Similarly, the correlation between lung ultrasound and ELWI was significant r=0.770 (95%CI: [0.58; 0.88]; P < 0.001). Conclusions: Clinical management of critically ill patients can be achieved via monitoring techniques, such as PICCO and AI-powered ultrasound.

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Haemodynamic Measurements (Continuous Cardiac Output and Systemic Vascular Resistance) in Critically Ill Patients: Transoesophageal Doppler versus Continuous Thermodilution

Anaesthesia and Intensive Care ◽

10.1177/0310057x9902700106 ◽

1999 ◽

Vol 27 (1) ◽

pp. 33-37 ◽

Cited By ~ 27

Author(s):

C. Baillard ◽

Y. Cohen ◽

J. P. Fosse ◽

P. Karoubi ◽

P. Hoang ◽

...

Keyword(s):

Cardiac Output ◽

Critically Ill ◽

Systemic Vascular Resistance ◽

Vascular Resistance ◽

Critically Ill Patients ◽

Continuous Cardiac Output

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Clinical evaluation of a partial CO2 rebreathing technique for cardiac output monitoring in critically ill patients

Acta Anaesthesiologica Scandinavica ◽

10.1034/j.1399-6576.2002.t01-1-460205.x ◽

2002 ◽

Vol 46 (2) ◽

pp. 152-159 ◽

Cited By ~ 53

Author(s):

H. Odenstedt ◽

O. Stenqvist ◽

S. Lundin

Keyword(s):

Cardiac Output ◽

Critically Ill ◽

Clinical Evaluation ◽

Critically Ill Patients ◽

Cardiac Output Monitoring ◽

Co2 Rebreathing ◽

Output Monitoring

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Feasibility of cardiac output measurements in critically ill patients by medical students

The Ultrasound Journal ◽

10.1186/s13089-020-0152-5 ◽

2020 ◽

Vol 12 (1) ◽

Author(s):

Geert Koster ◽

Thomas Kaufmann ◽

Bart Hiemstra ◽

Renske Wiersema ◽

Madelon E. Vos ◽

...

Keyword(s):

Cardiac Output ◽

Critical Care ◽

Medical Students ◽

Critically Ill ◽

Critically Ill Patients ◽

Left Ventricular ◽

Percentage Error ◽

Poor Agreement ◽

Cardiac Output Measurements

Abstract Background Critical care ultrasonography (CCUS) is increasingly applied also in the intensive care unit (ICU) and performed by non-experts, including even medical students. There is limited data on the training efforts necessary for novices to attain images of sufficient quality. There is no data on medical students performing CCUS for the measurement of cardiac output (CO), a hemodynamic variable of importance for daily critical care. Objective The aim of this study was to explore the agreement of cardiac output measurements as well as the quality of images obtained by medical students in critically ill patients compared to the measurements obtained by experts in these images. Methods In a prospective observational cohort study, all acutely admitted adults with an expected ICU stay over 24 h were included. CCUS was performed by students within 24 h of admission. CCUS included the images required to measure the CO, i.e., the left ventricular outflow tract (LVOT) diameter and the velocity time integral (VTI) in the LVOT. Echocardiography experts were involved in the evaluation of the quality of images obtained and the quality of the CO measurements. Results There was an opportunity for a CCUS attempt in 1155 of the 1212 eligible patients (95%) and in 1075 of the 1212 patients (89%) CCUS examination was performed by medical students. In 871 out of 1075 patients (81%) medical students measured CO. Experts measured CO in 783 patients (73%). In 760 patients (71%) CO was measured by both which allowed for comparison; bias of CO was 0.0 L min−1 with limits of agreement of − 2.6 L min−1 to 2.7 L min−1. The percentage error was 50%, reflecting poor agreement of the CO measurement by students compared with the experts CO measurement. Conclusions Medical students seem capable of obtaining sufficient quality CCUS images for CO measurement in the majority of critically ill patients. Measurements of CO by medical students, however, had poor agreement with expert measurements. Experts remain indispensable for reliable CO measurements. Trial registration Clinicaltrials.gov; http://www.clinicaltrials.gov; registration number NCT02912624

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