Clinical validation of a computerized algorithm to determine mean systemic filling pressure

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dc.contributor.authorMeijs, Loek P. B.
dc.contributor.authorvan Houte, Joris
dc.contributor.authorConjaerts, Bente C. M.
dc.contributor.authorBindels, Alexander J. G. H.
dc.contributor.authorBouwman, Arthur
dc.contributor.authorHouterman, Saskia
dc.contributor.authorBakker, Jan
dc.date.accessioned2025-01-20T22:02:05Z
dc.date.available2025-01-20T22:02:05Z
dc.date.issued2022
dc.description.abstractMean systemic filling pressure (Pms) is a promising parameter in determining intravascular fluid status. Pms derived from venous return curves during inspiratory holds with incremental airway pressures (Pms-Insp) estimates Pms reliably but is labor-intensive. A computerized algorithm to calculate Pms (Pmsa) at the bedside has been proposed. In previous studies Pmsa and Pms-Insp correlated well but with considerable bias. This observational study was performed to validate Pmsa with Pms-Insp in cardiac surgery patients. Cardiac output, right atrial pressure and mean arterial pressure were prospectively recorded to calculate Pmsa using a bedside monitor. Pms-Insp was calculated offline after performing inspiratory holds. Intraclass-correlation coefficient (ICC) and assessment of agreement were used to compare Pmsa with Pms-Insp. Bias, coefficient of variance (COV), precision and limits of agreement (LOA) were calculated. Proportional bias was assessed with linear regression. A high degree of inter-method reliability was found between Pmsa and Pms-Insp (ICC 0.89; 95%CI 0.72-0.96, p = 0.01) in 18 patients. Pmsa and Pms-Insp differed not significantly (11.9 mmHg, IQR 9.8-13.4 vs. 12.7 mmHg, IQR 10.5-14.4, p = 0.38). Bias was -0.502 +/- 1.90 mmHg (p = 0.277). COV was 4% with LOA -4.22 - 3.22 mmHg without proportional bias. Conversion coefficient Pmsa -> Pms-Insp was 0.94. This assessment of agreement demonstrates that the measures Pms-Insp and the computerized Pmsa-algorithm are interchangeable (bias - 0.502 +/- 1.90 mmHg with conversion coefficient 0.94). The choice of Pmsa is straightforward, it is non-interventional and available continuously at the bedside in contrast to Pms-Insp which is interventional and calculated off-line. Further studies should be performed to determine the place of Pmsa in the circulatory management of critically ill patients.
dc.description.funderCatharina Hospital Intensive Care Research Fund
dc.fuente.origenWOS
dc.identifier.doi10.1007/s10877-020-00636-2
dc.identifier.eissn1573-2614
dc.identifier.issn1387-1307
dc.identifier.urihttps://doi.org/10.1007/s10877-020-00636-2
dc.identifier.urihttps://repositorio.uc.cl/handle/11534/93931
dc.identifier.wosidWOS:000635456900001
dc.issue.numero1
dc.language.isoen
dc.pagina.final198
dc.pagina.inicio191
dc.revistaJournal of clinical monitoring and computing
dc.rightsacceso restringido
dc.subjectMean systemic filling pressure
dc.subjectCardiac output
dc.subjectRight atrial pressure
dc.subjectVenous return
dc.subjectInspiratory hold
dc.subject.ods03 Good Health and Well-being
dc.subject.odspa03 Salud y bienestar
dc.titleClinical validation of a computerized algorithm to determine mean systemic filling pressure
dc.typeartículo
dc.volumen36
sipa.indexWOS
sipa.trazabilidadWOS;2025-01-12
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