• Laurent Bitker, Inès Noirot, Louis Chauvelot, Mehdi Mezidi, François Dhelft, Maxime Gaillet, Hodane Yonis, Guillaume Deniel, and Jean-Christophe Richard.
• Service de Médecine Intensive - Réanimation, Hôpital de la Croix Rousse, Hospices Civils de Lyon, Lyon, France.
• Crit Care Resusc. 2024 Jun 1; 26 (2): 108115108-115.

ObjectiveTo evaluate the accuracy of non-calibrated multi-beat analysis continuous cardiac output (CCOMBA), against calibrated pulse-contour analysis continuous cardiac output (CCOPCA) during a passive leg raise (PLR) and/or a fluid challenge (FC).DesignObservational, single-centre, prospective study.SettingTertiary academic medical intensive care unit, Lyon, France.ParticipantsAdult patients receiving norepinephrine, monitored by CCOPCA, and in which a PLR and/or a FC was indicated.Main Outcome MeasuresCCOMBA and CCOPCA were recorded prior to and during the PLR/FC to evaluate bias and evaluate changes in CCOMBA and CCOPCA (∆%CCOMBA and ∆%CCOPCA). Fluid responsiveness was identified by an increase >15% in calibrated cardiac output after FC, to identify the optimal ∆%CCOMBA threshold during PLR to predict fluid responsiveness.Results29 patients (median age 68 [IQR: 57-74]) performed 28 PLR and 16 FC. The bias between methods increased with higher CCOPCA values, with a percentage error of 64% (95%confidence interval: 52%-77%). ∆%CCOMBA adequately tracked changes in ∆%CCOPCA with an angular bias of 2 ± 29°. ∆%CCOMBA during PLR had an AUROC of 0.92 (P < 0.05), with an optimal threshold >14% to predict fluid responsiveness (sensitivity: 0.99, specificity: 0.87).ConclusionsCCOMBA showed a non-constant bias and a percentage error >30% against calibrated CCOPCA, but an adequate ability to track changes in CCOPCA and to predict fluid responsiveness.© 2024 The Authors.

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