Uncalibrated Continuous Cardiac Output Measurement in Liver Transplant Patients: LiDCOrapid™ System versus Pulmonary Artery Catheter

ObjectiveThe aim of the study was to assess the level of agreement between continuous cardiac output estimated by uncalibrated pulse-power analysis (PulseCOLiR) and intermittent (ICO) and continuous cardiac output (CCO) obtained using a pulmonary artery catheter (PAC).DesignProspective cohort study.SettingUniversity hospital intensive care unit.ParticipantsTwenty patients after liver transplantation.InterventionPulmonary artery catheters were placed in all patients, and ICO and CCO were determined using thermodilution. PulseCOLiR measurements were made using a LiDCOrapidTM (LiDCO Ltd, Cambridge, UK).Measurements and Main ResultsICO data were determined after intensive care unit admission and every 8 hours until the 48th postoperative hour. CCO and PulseCOLiR measurements were recorded simultaneously at these same time intervals as well as hourly. For the 8-hour data set (140 data pairs), the mean bias and percentage errors (PE) were, respectively,−0.10 L/min and 39.2% for ICO versus PulseCOLiR and 0.79 L/min and 34.6% for CCO versus PulseCOLiR. For the hourly comparison of CCO versus PulseCOLiR (980 data pairs), the bias was 0.75 L/min and the PE 37%. To assess the ability to measure change, a 4-quadrant plot was produced for each pair of methods. The performance of PulseCOLiR was moderate in detecting changes in ICO.ConclusionsIn conclusion, the uncalibrated PulseCOLir method should not be used as a substitute for the thermodilution technique for the monitoring of cardiac output in liver transplant patients.