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Cited by 512

The DOI matches its Crossref record; 55 of the 55 references it cites were found in a registry or an index.

A Critical Review of the Ability of Continuous Cardiac Output Monitors to Measure Trends in Cardiac Output

Critchley, Lester A., Lee, Anna, Ho, Anthony M.-H.·2010·Anesthesia & Analgesia

Abstract

Numerous cardiac output (CO) monitors have been produced that provide continuous rather than intermittent readings. Bland and Altman has become the standard method for validating their performance against older standards. However, the Bland and Altman method only assesses precision and does not assess how well a device detects serial changes in CO (trending ability). Currently, there is no consensus on how trending ability, or trend analysis, should be performed. Therefore, we performed a literature review to identify articles published between 1997 and 2009 that compared methods of continuous CO measurement. Identified articles were grouped according to measurement technique and statistical methodology. Articles that analyzed trending ability were reviewed with the aim of finding an acceptable statistical method. Two hundred two articles were identified. The most popular methods were pulse contour (69 articles), Doppler (54), bioimpedance (38), and transpulmonary or continuous thermodilution (27). Forty-one articles addressed trending, and of these only 23 provided an in-depth analysis. Several common statistical themes were identified: time plots, regression analysis, Bland and Altman using change in CO (ΔCO), and the 4-quadrant plot, which used direction of change of ΔCO to determine the concordance. This plot was further refined by exclusion of data when values were small. Receiver operating characteristic curves were used to define the exclusion zone. In animal studies, a reliable reference standard such as an aortic flowprobe was frequently used, and regression or time plots could be used to show trending. Clinical studies were more problematic because data collection points were fewer (8-10 per subject). The consensus was to use the 4-quadrant plot with exclusion zones and apply concordance analysis. A concordance rate of >92% when using a 15% zone indicated good trending. A new method of presenting trend data (ΔCO) on a polar plot is proposed. Agreement was shown by the angle with the horizontal axis and ΔCO by the distance from the center. Trending can be assessed by the vertical limits of the data, similar to the Bland and Altman method.

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Metadata

Authors
Critchley, L. A., Lee, A., & Ho, A. M.-H.
Venue
Anesthesia & Analgesia
Published
2010-11
Volume
111
Issue
5
Pages
1180-1192
ISSN
0003-2999 (ISSN-L)
OpenAlex
W2069216248
Cited by
512
References
55
FWCI
36.02
Type
journal article
Language
en
Open access
closed

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CoChat. (2026). Citation check: A Critical Review of the Ability of Continuous Cardiac Output Monitors to Measure Trends in Cardiac Output. https://app.cochat.ai/papers/10.1213/ane.0b013e3181f08a5b
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Critchley, L. A., Lee, A., & Ho, A. M.-H. (2010). A Critical Review of the Ability of Continuous Cardiac Output Monitors to Measure Trends in Cardiac Output. Anesthesia & Analgesia. https://doi.org/10.1213/ane.0b013e3181f08a5b

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Semantic Scholar’s data is described in: Kinney, R., et al. (2023). The Semantic Scholar Open Data Platform. arXiv:2301.10140.