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GW24-e3583 Agreement of stroke volume, cardiac output, and systemic vascular resistance between swan-ganz and echocardiography
  1. Andria Priyana1,
  2. M Soesanto Amiliana2,
  3. H Joesoef Andang2
  1. 1RSUD Cengkareng (Cengkareng District General Hospital)
  2. 2Department of Cardiology and Vascular Medicine, University of Indonesia

Abstract

Objectives Pulmonary artery catheter (PAC) until now is still considered as gold standard for haemodynamic measurement. It is, however, high cost, has complications risks, and has shown little benefit/risk ratio. It, therefore, makes many studies assessing correlation or agreement between non-invasive modalities with PAC for haemodynamic measurement. There were many studies for agreement between TransEsophageal Echocardiography (TEE) and PAC, while only few studies that assessed agreement between TTE and PAC for hemodynamic profiles, especially Systemic Vascular Resistance (SVR).

Methods This is an analytic cross-sectional study in post CABG patients in ICU whose PAC were performed. Hemodynamic measurement by TTE measuring LVOT diameter, VTI, IVC diameter that can be calculated into SV, CO, and SVR. There were three SVR categories: SVR1 using top limit of estRAp, SVR2 using bottom limit of estRAp, and SVR3 using mean of estRAp. Statistic analysis used paired t-test for mean comparison. Agreement analysis used bland-altman method. Intraobserver and interobserver variability were assessed by intraclass correlation (ICC) and repeatibility coefficient (RC). Percentage error was calculated as follows: twice the SD for the difference between the two methods being compared was divided by the mean value obtained from both methods. Data was analysed by SPSS 15.0

Results There were 50 data from 28 samples. Bias/mean difference between TEE and PAC were: 0,11 for SV; 0,03 for CO; -15,76 for SVR1; 67,75 for SVR2; 25,99 for SVR3. There were also good agreement between methods with quite narrow limits of agreement (SV -15, 22; 15, 44, CO -1, 30; 1, 36, SVR1 -293, 18; 261, 66, SVR2 -220, 10; 355, 60, SVR3 -256, 23; 308, 21.

Conclusions There is good agreement between TTE and PAC for measuring SV, CO, and SVR. Therefore, TTE can be used as an easy-to-use alternative to evaluate hemodynamic variables.

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