Two Methods of Hemodynamic and Volume Status Assessment in Critically Ill Patients

Introduction:The invasive nature and potential complications associated with pulmonary artery (PA) catheters (PACs) have prompted the pursuit of less invasive monitoring options. Before implementing new hemodynamic monitoring technologies, it is important to determine the interchangeability of these modalities. This study examines monitoring concordance between the PAC and the arterial waveform analysis (AWA) hemodynamic monitoring system.Methods:Critically ill patients undergoing hemodynamic monitoring with PAC were simultaneously equipped with the FloTrac AWA system (both from Edwards Lifesciences, Irvine, California). Data were concomitantly obtained for hemodynamic variables. Bland-Altman methodology was used to assess CO measurement bias and κ coefficent to show discrepancies in intravascular volume.Results:Significant measurement bias was observed in both CO and intravascular volume status between the 2 techniques (mean bias, −1.055 ± 0.263 liter/min, r = 0.481). There was near-complete lack of agre...