• Takuma Maeda, Kenji Yoshitani, Yuzuru Inatomi, and Yoshihiko Ohnishi.
• Department of Anesthesiology, National Cerebral and Cardiovascular Center, Osaka, Japan. Electronic address: takuma@ncvc.go.jp.
• J. Cardiothorac. Vasc. Anesth.. 2014 Dec 1;28(6):1521-6.

ObjectivesThe goal of this study was to compare cardiac output derived from the FloTrac/Vigileo™ system (CO(FT)) with cardiac output measured by 3-dimensional transesophageal echocardiography (CO3D) in patients with severe heart failure undergoing cardiac resynchronization therapy. The impact of preoperative systemic vascular resistance index on the accuracy of the FloTrac/Vigileo™ system also was investigated.DesignProspective clinical study.SettingCardiac surgery operating room of a single cardiovascular center.ParticipantsForty-one patients undergoing elective cardiac resynchronization therapy lead implantation.InterventionsCO3D as the reference method and CO(FT) were determined simultaneously after induction of anesthesia.Measurements And Main ResultsLinear regression analysis showed a poor correlation between CO3D and CO(FT) (R² = 0.16). Bland-Altman plots showed wide limits of agreement between CO3D and CO(FT.). Bias was 0.60 ± 0.63 L/min with a high percentage error of 58.2%. Subgroup analysis showed that the percentage error between CO3D and CO(FT) was 74.1% in patients with a cardiac index<2.2 L/min/m(2) and 17.2% in patients with a cardiac index ≥ 2.2 L/min/m(2). Systemic vascular resistance index was significantly higher in patients with a cardiac index<2.2 L/min/m(2) (3,037 ± 820 v 2,461 ± 878; p = 0.039).ConclusionsThe FloTrac/Vigileo™ system is not accurate in patients with low cardiac output, especially those with a cardiac index<2.2 L/min/m(2). A high systemic vascular resistance index in patients with low cardiac index may contribute to this inaccuracy.Copyright © 2014 Elsevier Inc. All rights reserved.

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