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Purpose <p>Stroke volume variation (SVV) is a dynamic parameter used to assess fluid responsiveness in mechanically ventilated patients. This study aimed to evaluate the agreement and trending ability of SVV measurements obtained from bioreactance (Starling SV) and arterial waveform analysis devices (FloTrac and LiDCOrapid) during cardiac surgery.</p> Methods <p>This prospective observational method comparison study was conducted in a single university hospital. 18 patients undergoing off-pump coronary artery bypass grafting (OPCAB) were monitored with Starling SV and FloTrac. 20 patients undergoing cardiac surgery with cardiopulmonary bypass (CPB) were monitored with Starling SV and LiDCOrapid. SVV measurements were collected intraoperatively and postoperatively. Agreement and trending ability between devices were assessed using Bland–Altman analysis and four-quadrant plots with error grids and concordance analysis.</p> Results <p>A total of 2055 paired SVV measurements were obtained in the OPCAB group and 367 in the CPB group. The mean bias between Starling SV and FloTrac was 2.3%pt (95% CI 2.1 to 2.6) with wide limits of agreement (-14.3 to 20.5%pt). For Starling SV and LiDCOrapid, the bias was 1.5%pt (95% CI 0.9 to 2.2) with very wide limits of agreement (-38.3 to 38.4%pt). Trending ability was poor in all comparisons.</p> Conclusion <p>Despite acceptable mean biases, the variability between devices was considerable, and trending analyses indicated only limited concordance. The studied SVV monitors, therefore, cannot be considered interchangeable in the context of cardiac surgery. These findings highlight the limitations and uncertainty of SVV monitoring in this setting.</p>

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Reliability of bioreactance and arterial waveform analyses in monitoring stroke volume variation during cardiac surgery

  • 期刊论文

  • 发表日期：

    2025年11月24日

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  • Sanna Tuuli Marja Paaso,
  • Pasi Antero Tuukkanen,
  • Suvi Eveliina Niemi,
  • Pasi Petteri Ohtonen,
  • Panu Tuomas Piirainen,
  • Laura Anneli Ylikauma,
  • Katriina Marjatta Lanning,
  • Mari Johanna Pohjola,
  • Tiina Maria Erkinaro,
  • Timo Ilari Kaakinen

摘要

Purpose

Stroke volume variation (SVV) is a dynamic parameter used to assess fluid responsiveness in mechanically ventilated patients. This study aimed to evaluate the agreement and trending ability of SVV measurements obtained from bioreactance (Starling SV) and arterial waveform analysis devices (FloTrac and LiDCOrapid) during cardiac surgery.

Methods

This prospective observational method comparison study was conducted in a single university hospital. 18 patients undergoing off-pump coronary artery bypass grafting (OPCAB) were monitored with Starling SV and FloTrac. 20 patients undergoing cardiac surgery with cardiopulmonary bypass (CPB) were monitored with Starling SV and LiDCOrapid. SVV measurements were collected intraoperatively and postoperatively. Agreement and trending ability between devices were assessed using Bland–Altman analysis and four-quadrant plots with error grids and concordance analysis.

Results

A total of 2055 paired SVV measurements were obtained in the OPCAB group and 367 in the CPB group. The mean bias between Starling SV and FloTrac was 2.3%pt (95% CI 2.1 to 2.6) with wide limits of agreement (-14.3 to 20.5%pt). For Starling SV and LiDCOrapid, the bias was 1.5%pt (95% CI 0.9 to 2.2) with very wide limits of agreement (-38.3 to 38.4%pt). Trending ability was poor in all comparisons.

Conclusion

Despite acceptable mean biases, the variability between devices was considerable, and trending analyses indicated only limited concordance. The studied SVV monitors, therefore, cannot be considered interchangeable in the context of cardiac surgery. These findings highlight the limitations and uncertainty of SVV monitoring in this setting.