SynthesisBritish journal of anaesthesia2026
Agreement of minimally invasive pulse wave analysis with pulmonary artery and transpulmonary thermodilution cardiac output measurements in perioperative and intensive care medicine: a systematic review and meta-analysis.
Synthesis in British journal of anaesthesia, 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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10 authors.
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Abstract
backgroundCardiac output monitoring is recommended for high-risk surgical patients and critically ill patients with circulatory shock. We performed a systematic review and meta-analysis of clinical studies published since 2010 that compared minimally invasive pulse wave analysis-derived cardiac output or cardiac index measurements with reference measurements by pulmonary artery thermodilution or transpulmonary thermodilution in adult surgical or critically ill patients.
methodsIn a random-effects meta-analysis, we calculated pooled estimates of the percentage error, mean difference and standard deviation, and 95% limits of agreement separately for studies reporting cardiac output or cardiac index. Subgroup analyses were performed by patient population and test device.
resultsWe included 92 studies divided into 113 data sets with a total of 3111 patients. For 71 data sets reporting cardiac output, the pooled percentage error (95% confidence interval [95% CI]) was 44.0% (38.2%-49.8%) with a mean difference (standard deviation) of -0.1 (1.3) L min
conclusionsThe pooled percentage error between minimally invasive pulse wave analysis-derived cardiac output measurements of 44.0% (cardiac output) and 49.1% (cardiac index) in adult surgical or critically ill patients exceeds the 30% threshold for clinically acceptable agreement. However, the percentage error varied depending on the patient population and device used.
trial registrationPROSPERO (CRD420251090806; submitted July 17, 2025).
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