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Title: The effect of head up tilting on bioreactance cardiac output and stroke volume readings using suprasternal transcutaneous doppler as a control in healthy young adults
Authors: Zhang, J
Critchley, LAH
Lee, DCW
Khaw, KS
Lee, SWY 
Keywords: Cardiac output
Head up tilting
Issue Date: 2016
Publisher: Springer
Source: Journal of clinical monitoring and computing, 2016, v. 30, no. 5, p. 519-526 How to cite?
Journal: Journal of clinical monitoring and computing 
Abstract: To compare the performance of a bioreactance cardiac output (CO) monitor (NICOM) and transcutaneous Doppler (USCOM) during head up tilting (HUT). Healthy young adult subjects, age 22 +/- 1 years, 7 male and 7 female, were tilted over 3-5 s from supine to 70A degrees HUT, 30A degrees HUT and back to supine. Positions were held for 3 min. Simultaneous readings of NICOM and USCOM were performed 30 s into each new position. Mean blood pressure (MBP), heart rate (HR), CO and stroke volume (SV), and thoracic fluid content (TFC) were recorded. Bland-Altman, percentage changes and analysis of variance for repeated measures were used for statistical analysis. Pre-tilt NICOM CO and SV readings (6.1 +/- 1.0 L/min and 113 +/- 25 ml) were higher than those from USCOM (4.1 +/- 0.6 L/min and 77 +/- 9 ml) (P < 0.001). Bland-Altman limits of agreement for CO were wide with a percentage error of 38 %. HUT increased MBP and HR (P < 0.001). CO and SV readings decreased with HUT. However, the percentage changes in USCOM and NICOM readings did not concur (P < 0.001). Whereas USCOM provided gravitational effect proportional changes in SV readings of 23 +/- 15 % (30A degrees half tilt) and 44 +/- 11 % (70A degrees near full tilt), NICOM changes did not being 28 +/- 10 and 33 +/- 11 %. TFC decreased linearly with HUT. The NICOM does not provide linear changes in SV as predicted by physiology when patients are tilted. Furthermore there is a lack of agreement with USCOM measurements at baseline and during tilting.
ISSN: 1387-1307
DOI: 10.1007/s10877-016-9835-7
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