Validation of stroke volume and cardiac output by electrical interrogation of the brachial artery in normals: assessment of strengths, limitations, and sources of error

Verfasser / Beitragende:
[Donald Bernstein, Isaac Henry, Harry Lemmens, Janell Chaltas, Anthony DeMaria, James Moon, Andrew Kahn]
Ort, Verlag, Jahr:
2015
Enthalten in:
Journal of Clinical Monitoring and Computing, 29/6(2015-12-01), 789-800
Format:
Artikel (online)
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024 7 0 |a 10.1007/s10877-015-9668-9  |2 doi 
035 |a (NATIONALLICENCE)springer-10.1007/s10877-015-9668-9 
245 0 0 |a Validation of stroke volume and cardiac output by electrical interrogation of the brachial artery in normals: assessment of strengths, limitations, and sources of error  |h [Elektronische Daten]  |c [Donald Bernstein, Isaac Henry, Harry Lemmens, Janell Chaltas, Anthony DeMaria, James Moon, Andrew Kahn] 
520 3 |a The goal of this study is to validate a new, continuous, noninvasive stroke volume (SV) method, known as transbrachial electrical bioimpedance velocimetry (TBEV). TBEV SV was compared to SV obtained by cardiac magnetic resonance imaging (cMRI) in normal humans devoid of clinically apparent heart disease. Thirty-two (32) volunteers were enrolled in the study. Each subject was evaluated by echocardiography to assure that no aortic or mitral valve disease was present. Subsequently, each subject underwent electrical interrogation of the brachial artery by means of a high frequency, low amplitude alternating current. A first TBEV SV estimate was obtained. Immediately after the initial TBEV study, subjects underwent cMRI, using steady-state precession imaging to obtain a volumetric estimate of SV. Following cMRI, the TBEV SV study was repeated. Comparing the cMRI-derived SV to that of TBEV, the two TBEV estimates were averaged and compared to the cMRI standard. CO was computed as the product of SV and heart rate. Statistical methods consisted of Bland-Altman and linear regression analysis. TBEV SV and CO estimates were obtained in 30 of the 32 subjects enrolled. Bland-Altman analysis of pre- and post-cMRI TBEV SV showed a mean bias of 2.87 % (2.05mL), precision of 13.59% (11.99mL) and 95% limits of agreement (LOA) of +29.51% (25.55mL) and −23.77% (−21.45mL). Regression analysis for pre- and post-cMRI TBEV SV values yielded y=0.76x+25.1 and r2=0.71 (r=0.84). Bland-Altman analysis comparing cMRI SV with averaged TBEV SV showed a mean bias of −1.56% (−1.53mL), precision of 13.47% (12.84mL), 95% LOA of +24.85% (+23.64mL) and −27.97% (−26.7mL) and percent error=26.2%. For correlation analysis, the regression equation was y=0.82x+19.1 and correlation coefficient r2=0.61 (r=0.78). Bland-Altman analysis of averaged pre- and post-cMRI TBEV CO versus cMRI CO yielded a mean bias of 5.01% (0.32Lmin−1), precision of 12.85% (0.77Lmin−1), 95% LOA of +30.20% (+0.1.83Lmin−1) and −20.7% (−1.19Lmin−1) and percent error=24.8%. Regression analysis yielded y=0.92x+0.78, correlation coefficient r2=0.74 (r=0.86). TBEV is a novel, noninvasive method, which provides satisfactory estimates of SV and CO in normal humans. 
540 |a The Author(s), 2015 
690 7 |a Stroke volume  |2 nationallicence 
690 7 |a Cardiac output  |2 nationallicence 
690 7 |a Noninvasive  |2 nationallicence 
690 7 |a Transbrachial electrical velocimetry  |2 nationallicence 
690 7 |a Impedance cardiography  |2 nationallicence 
700 1 |a Bernstein  |D Donald  |u Sotera Wireless, Inc., 10020 Huennekens Street, 92121, San Diego, CA, USA  |4 aut 
700 1 |a Henry  |D Isaac  |u Sotera Wireless, Inc., 10020 Huennekens Street, 92121, San Diego, CA, USA  |4 aut 
700 1 |a Lemmens  |D Harry  |u Department of Anesthesia, Stanford University School of Medicine, 94305-5115, Stanford, CA, USA  |4 aut 
700 1 |a Chaltas  |D Janell  |u Sotera Wireless, Inc., 10020 Huennekens Street, 92121, San Diego, CA, USA  |4 aut 
700 1 |a DeMaria  |D Anthony  |u Department of Medicine, University of California San Diego School of Medicine, 92103, San Diego, CA, USA  |4 aut 
700 1 |a Moon  |D James  |u Sotera Wireless, Inc., 10020 Huennekens Street, 92121, San Diego, CA, USA  |4 aut 
700 1 |a Kahn  |D Andrew  |u Department of Medicine, University of California San Diego School of Medicine, 92103, San Diego, CA, USA  |4 aut 
773 0 |t Journal of Clinical Monitoring and Computing  |d Springer Netherlands  |g 29/6(2015-12-01), 789-800  |x 1387-1307  |q 29:6<789  |1 2015  |2 29  |o 10877 
856 4 0 |u https://doi.org/10.1007/s10877-015-9668-9  |q text/html  |z Onlinezugriff via DOI 
898 |a BK010053  |b XK010053  |c XK010000 
900 7 |a Metadata rights reserved  |b Springer special CC-BY-NC licence  |2 nationallicence 
908 |D 1  |a research-article  |2 jats 
949 |B NATIONALLICENCE  |F NATIONALLICENCE  |b NL-springer 
950 |B NATIONALLICENCE  |P 856  |E 40  |u https://doi.org/10.1007/s10877-015-9668-9  |q text/html  |z Onlinezugriff via DOI 
950 |B NATIONALLICENCE  |P 700  |E 1-  |a Bernstein  |D Donald  |u Sotera Wireless, Inc., 10020 Huennekens Street, 92121, San Diego, CA, USA  |4 aut 
950 |B NATIONALLICENCE  |P 700  |E 1-  |a Henry  |D Isaac  |u Sotera Wireless, Inc., 10020 Huennekens Street, 92121, San Diego, CA, USA  |4 aut 
950 |B NATIONALLICENCE  |P 700  |E 1-  |a Lemmens  |D Harry  |u Department of Anesthesia, Stanford University School of Medicine, 94305-5115, Stanford, CA, USA  |4 aut 
950 |B NATIONALLICENCE  |P 700  |E 1-  |a Chaltas  |D Janell  |u Sotera Wireless, Inc., 10020 Huennekens Street, 92121, San Diego, CA, USA  |4 aut 
950 |B NATIONALLICENCE  |P 700  |E 1-  |a DeMaria  |D Anthony  |u Department of Medicine, University of California San Diego School of Medicine, 92103, San Diego, CA, USA  |4 aut 
950 |B NATIONALLICENCE  |P 700  |E 1-  |a Moon  |D James  |u Sotera Wireless, Inc., 10020 Huennekens Street, 92121, San Diego, CA, USA  |4 aut 
950 |B NATIONALLICENCE  |P 700  |E 1-  |a Kahn  |D Andrew  |u Department of Medicine, University of California San Diego School of Medicine, 92103, San Diego, CA, USA  |4 aut 
950 |B NATIONALLICENCE  |P 773  |E 0-  |t Journal of Clinical Monitoring and Computing  |d Springer Netherlands  |g 29/6(2015-12-01), 789-800  |x 1387-1307  |q 29:6<789  |1 2015  |2 29  |o 10877