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Estimation of pulse pressure variation and cardiac output in patients having major abdominal surgery: a comparison between a mobile application for snapshot pulse wave analysis and invasive pulse wave analysis

Pulse pressure variation (PPV) and cardiac output (CO) can guide perioperative fluid management. Capstesia (Galenic App, Vitoria-Gasteiz, Spain) is a mobile application for snapshot pulse wave analysis (PWAsnap) and estimates PPV and CO using pulse wave analysis of a snapshot of the arterial blood p...

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Autores principales: Hoppe, Phillip, Gleibs, Fabian, Briesenick, Luisa, Joosten, Alexandre, Saugel, Bernd
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Springer Netherlands 2020
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8497332/
https://www.ncbi.nlm.nih.gov/pubmed/32749570
http://dx.doi.org/10.1007/s10877-020-00572-1
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author Hoppe, Phillip
Gleibs, Fabian
Briesenick, Luisa
Joosten, Alexandre
Saugel, Bernd
author_facet Hoppe, Phillip
Gleibs, Fabian
Briesenick, Luisa
Joosten, Alexandre
Saugel, Bernd
author_sort Hoppe, Phillip
collection PubMed
description Pulse pressure variation (PPV) and cardiac output (CO) can guide perioperative fluid management. Capstesia (Galenic App, Vitoria-Gasteiz, Spain) is a mobile application for snapshot pulse wave analysis (PWAsnap) and estimates PPV and CO using pulse wave analysis of a snapshot of the arterial blood pressure waveform displayed on any patient monitor. We evaluated the PPV and CO measurement performance of PWAsnap in adults having major abdominal surgery. In a prospective study, we simultaneously measured PPV and CO using PWAsnap installed on a tablet computer (PPV(PWAsnap), CO(PWAsnap)) and using invasive internally calibrated pulse wave analysis (ProAQT; Pulsion Medical Systems, Feldkirchen, Germany; PPV(ProAQT), CO(ProAQT)). We determined the diagnostic accuracy of PPV(PWAsnap) in comparison to PPV(ProAQT) according to three predefined PPV categories and by computing Cohen’s kappa coefficient. We compared CO(ProAQT) and CO(PWAsnap) using Bland-Altman analysis, the percentage error, and four quadrant plot/concordance rate analysis to determine trending ability. We analyzed 190 paired PPV and CO measurements from 38 patients. The overall diagnostic agreement between PPV(PWAsnap) and PPV(ProAQT) across the three predefined PPV categories was 64.7% with a Cohen’s kappa coefficient of 0.45. The mean (± standard deviation) of the differences between CO(PWAsnap) and CO(ProAQT) was 0.6 ± 1.3 L min(− 1) (95% limits of agreement 3.1 to − 1.9 L min(− 1)) with a percentage error of 48.7% and a concordance rate of 45.1%. In adults having major abdominal surgery, PPV(PWAsnap) moderately agrees with PPV(ProAQT). The absolute and trending agreement between CO(PWAsnap) with CO(ProAQT) is poor. Technical improvements are needed before PWAsnap can be recommended for hemodynamic monitoring.
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spelling pubmed-84973322021-10-19 Estimation of pulse pressure variation and cardiac output in patients having major abdominal surgery: a comparison between a mobile application for snapshot pulse wave analysis and invasive pulse wave analysis Hoppe, Phillip Gleibs, Fabian Briesenick, Luisa Joosten, Alexandre Saugel, Bernd J Clin Monit Comput Original Research Pulse pressure variation (PPV) and cardiac output (CO) can guide perioperative fluid management. Capstesia (Galenic App, Vitoria-Gasteiz, Spain) is a mobile application for snapshot pulse wave analysis (PWAsnap) and estimates PPV and CO using pulse wave analysis of a snapshot of the arterial blood pressure waveform displayed on any patient monitor. We evaluated the PPV and CO measurement performance of PWAsnap in adults having major abdominal surgery. In a prospective study, we simultaneously measured PPV and CO using PWAsnap installed on a tablet computer (PPV(PWAsnap), CO(PWAsnap)) and using invasive internally calibrated pulse wave analysis (ProAQT; Pulsion Medical Systems, Feldkirchen, Germany; PPV(ProAQT), CO(ProAQT)). We determined the diagnostic accuracy of PPV(PWAsnap) in comparison to PPV(ProAQT) according to three predefined PPV categories and by computing Cohen’s kappa coefficient. We compared CO(ProAQT) and CO(PWAsnap) using Bland-Altman analysis, the percentage error, and four quadrant plot/concordance rate analysis to determine trending ability. We analyzed 190 paired PPV and CO measurements from 38 patients. The overall diagnostic agreement between PPV(PWAsnap) and PPV(ProAQT) across the three predefined PPV categories was 64.7% with a Cohen’s kappa coefficient of 0.45. The mean (± standard deviation) of the differences between CO(PWAsnap) and CO(ProAQT) was 0.6 ± 1.3 L min(− 1) (95% limits of agreement 3.1 to − 1.9 L min(− 1)) with a percentage error of 48.7% and a concordance rate of 45.1%. In adults having major abdominal surgery, PPV(PWAsnap) moderately agrees with PPV(ProAQT). The absolute and trending agreement between CO(PWAsnap) with CO(ProAQT) is poor. Technical improvements are needed before PWAsnap can be recommended for hemodynamic monitoring. Springer Netherlands 2020-08-04 2021 /pmc/articles/PMC8497332/ /pubmed/32749570 http://dx.doi.org/10.1007/s10877-020-00572-1 Text en © The Author(s) 2020 https://creativecommons.org/licenses/by/4.0/Open AccessThis article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/ (https://creativecommons.org/licenses/by/4.0/) .
spellingShingle Original Research
Hoppe, Phillip
Gleibs, Fabian
Briesenick, Luisa
Joosten, Alexandre
Saugel, Bernd
Estimation of pulse pressure variation and cardiac output in patients having major abdominal surgery: a comparison between a mobile application for snapshot pulse wave analysis and invasive pulse wave analysis
title Estimation of pulse pressure variation and cardiac output in patients having major abdominal surgery: a comparison between a mobile application for snapshot pulse wave analysis and invasive pulse wave analysis
title_full Estimation of pulse pressure variation and cardiac output in patients having major abdominal surgery: a comparison between a mobile application for snapshot pulse wave analysis and invasive pulse wave analysis
title_fullStr Estimation of pulse pressure variation and cardiac output in patients having major abdominal surgery: a comparison between a mobile application for snapshot pulse wave analysis and invasive pulse wave analysis
title_full_unstemmed Estimation of pulse pressure variation and cardiac output in patients having major abdominal surgery: a comparison between a mobile application for snapshot pulse wave analysis and invasive pulse wave analysis
title_short Estimation of pulse pressure variation and cardiac output in patients having major abdominal surgery: a comparison between a mobile application for snapshot pulse wave analysis and invasive pulse wave analysis
title_sort estimation of pulse pressure variation and cardiac output in patients having major abdominal surgery: a comparison between a mobile application for snapshot pulse wave analysis and invasive pulse wave analysis
topic Original Research
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8497332/
https://www.ncbi.nlm.nih.gov/pubmed/32749570
http://dx.doi.org/10.1007/s10877-020-00572-1
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