Observational studyJournal of clinical monitoring and computing2026
Reliability of bioreactance and arterial waveform analyses in monitoring stroke volume variation during cardiac surgery.
Observational study in Journal of clinical monitoring and computing, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
purposeStroke 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.
methodsThis 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.
resultsA 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.
conclusionDespite 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.
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