CLINICAL-EVALUATION OF THE ABBOTT QVUE-OPTIQ CONTINUOUS CARDIAC-OUTPUT SYSTEM IN CRITICALLY ILL MEDICAL PATIENTS

Purpose: The aim of this study was to evaluate the reliability of a ne w continuous cardiac output (CCO) monitoring device (Qvue/OptiQ system ; Abbott Critical Care Systems, Mountain View, CA) based on the pulsed warm thermodilution technique in critically ill medical patients. Met hods: Nineteen patients with cardiogenic or septic shock were included in the study. Pairs of CCO and intermittent bolus cardiac output (ICO ) were noted at least every 6 hours for determination of bias, precisi on, and limits of agreement. Simultaneously, blood samples were collec ted, and arterial-venous oxygen content difference (C[a-V]O-2) was det ermined. A multiple stepwise logistic regression was used to identify situations associated with a CCO-ICO difference exceeded 20%. A multip le linear regression was performed to analyze the respective accuracy of CCO and ICO to predict the variations of C[a-v]O-2. Results: A tota l of 203 pairs of cardiac output measurements was obtained, The bias w as 0.12 L/min (1.2% of pairs mean) and the precision 1.0 L/min (13%). The 95% limits of agreement were between -1.7 L/min (-25%) and 1.9 L/m in (+26%), Low blood temperatures and heart rates above 120 beats/min were significantly associated with a ICO-CCO difference higher than 20 %. In a multiple linear regression, CCO was significantly correlated w ith C[a-v]O-2, an independent reflection of the patient's cardiac outp ut; by contrast, ICO did not. Conclusion: These results suggest that I CO and CCO measurement by the Qvue/OptiQ system are interchangeable, e xcept for temperature or heart rate extreme values. Copyright (C) 1998 by W.B. Saunders Company.