Non-invasive cardiac output measurement with electrical velocimetry in patients undergoing liver transplantation: Comparison of an invasive method with pulmonary thermodilution

Background: The goal of this study was to evaluate the accuracy and interchangeability between continuous cardiac output (CO) measured by electrical velocimetry (CO_Ev) and continuous cardiac output obtained using the pulmonary thermodilution method (CO_PAC) during living donor liver transplantation (LDLT). Method: Twenty-three patients were enrolled in this prospective observational study. CO was recorded by both two methods and compared at nine specific time points. The data were analyzed using correlation coefficients, Bland-Altman analysis for the percentage errors, and the concordance rate for trend analysis using a four-quadrant plot. Results: In total, 207 paired datasets were recorded during LDLT. CO data were in the range of 2.8-12.7 L/min measured by PAC and 3.4-14.9 L/min derived from the EV machine. The correction coefficient between CO_PAC and CO_Ev was 0.415 with p < 0.01. The 95% limitation agreement was - 5.9 to 3.4 L/min and the percentage error was 60%. The concordance rate was 56.5%. Conclusions: The Aesculon™ monitor is not yet interchangeable with continuous thermodilution CO monitoring during LDLT.