caa a22 4500 605510164 CHVBK 20210128100644.0 cr unu---uuuuu 210128e20150801xx s 000 0 eng 10.1007/s10877-014-9624-0 doi (NATIONALLICENCE)springer-10.1007/s10877-014-9624-0 Reliability of a new 4th generation FloTrac algorithm to track cardiac output changes in patients receiving phenylephrine [Elektronische Daten] [Fuhai Ji, Jian Li, Neal Fleming, David Rose, Hong Liu] Phenylephrine is often used to treat intra-operative hypotension. Previous studies have shown that the FloTrac cardiac monitor may overestimate cardiac output (CO) changes following phenylephrine administration. A new algorithm (4th generation) has been developed to improve performance in this setting. We performed a prospective observational study to assess the effects of phenylephrine administration on CO values measured by the 3rd and 4th generation FloTrac algorithms. 54 patients were enrolled in this study. We used the Nexfin, a pulse contour method shown to be insensitive to vasopressor administration, as the reference method. Radial arterial pressures were recorded continuously in patients undergoing surgery. Phenylephrine administration times were documented. Arterial pressure recordings were subsequently analyzed offline using three different pulse contour analysis algorithms: FloTrac 3rd generation (G3), FloTrac 4th generation (G4), and Nexfin (nf). One minute of hemodynamic measurements was analyzed immediately before phenylephrine administration and then repeated when the mean arterial pressure peaked. A total of 157 (4.6±3.2 per patient, range 1-15) paired sets of hemodynamic recordings were analyzed. Phenylephrine induced a significant increase in stroke volume (SV) and CO with the FloTrac G3, but not with FloTrac G4 or Nexfin algorithms. Agreement between FloTrac G3 and Nexfin was: 0.23±1.19l/min and concordance was 51.1%. In contrast, agreement between FloTrac G4 and Nexfin was: 0.19±0.86l/min and concordance was 87.2%. In conclusion, the pulse contour method of measuring CO, as implemented in FloTrac 4th generation algorithm, has significantly improved its ability to track the changes in CO induced by phenylephrine. Springer Science+Business Media New York, 2014 Arterial pressure nationallicence Phenylephrine nationallicence Stroke volume nationallicence Pulse contour analysis nationallicence Ji Fuhai Department of Anesthesiology and Pain Medicine, University of California Davis Health System, 4150V Street, Suite 1200, 95817, Sacramento, CA, USA aut Li Jian Department of Anesthesiology, First Affiliated Hospital of Soochow University, Suzhou, Jiangsu, China aut Fleming Neal Department of Anesthesiology and Pain Medicine, University of California Davis Health System, 4150V Street, Suite 1200, 95817, Sacramento, CA, USA aut Rose David Department of Anesthesiology and Pain Medicine, University of California Davis Health System, 4150V Street, Suite 1200, 95817, Sacramento, CA, USA aut Liu Hong Department of Anesthesiology and Pain Medicine, University of California Davis Health System, 4150V Street, Suite 1200, 95817, Sacramento, CA, USA aut Journal of Clinical Monitoring and Computing Springer Netherlands 29/4(2015-08-01), 467-473 1387-1307 29:4<467 2015 29 10877 https://doi.org/10.1007/s10877-014-9624-0 text/html Onlinezugriff via DOI BK010053 XK010053 XK010000 Metadata rights reserved Springer special CC-BY-NC licence nationallicence 1 research-article jats NATIONALLICENCE NATIONALLICENCE NL-springer NATIONALLICENCE 856 40 https://doi.org/10.1007/s10877-014-9624-0 text/html Onlinezugriff via DOI NATIONALLICENCE 700 1- Ji Fuhai Department of Anesthesiology and Pain Medicine, University of California Davis Health System, 4150V Street, Suite 1200, 95817, Sacramento, CA, USA aut NATIONALLICENCE 700 1- Li Jian Department of Anesthesiology, First Affiliated Hospital of Soochow University, Suzhou, Jiangsu, China aut NATIONALLICENCE 700 1- Fleming Neal Department of Anesthesiology and Pain Medicine, University of California Davis Health System, 4150V Street, Suite 1200, 95817, Sacramento, CA, USA aut NATIONALLICENCE 700 1- Rose David Department of Anesthesiology and Pain Medicine, University of California Davis Health System, 4150V Street, Suite 1200, 95817, Sacramento, CA, USA aut NATIONALLICENCE 700 1- Liu Hong Department of Anesthesiology and Pain Medicine, University of California Davis Health System, 4150V Street, Suite 1200, 95817, Sacramento, CA, USA aut NATIONALLICENCE 773 0- Journal of Clinical Monitoring and Computing Springer Netherlands 29/4(2015-08-01), 467-473 1387-1307 29:4<467 2015 29 10877