ArticleIndian journal of anaesthesia2026
Comparison of cardiac index values between bioimpedance and pulse contour analysis in patients undergoing cardiac surgery under cardiopulmonary bypass.
Article in Indian 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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Abstract
Background and Aims: The performance of non-invasive techniques remains inconsistent in cardiac surgical patients. This study assessed the level of agreement and trending abilities of cardiac index (CI) values obtained using Noninvasive Cardiac System (NICaS™) and FloTrac™ (version 4.0) in adult patients undergoing cardiac surgery. Methods: This retrospective observational study was conducted over 6 months at a tertiary care centre and included 16 patients undergoing elective cardiac surgery with cardiopulmonary bypass. CI was measured simultaneously using FloTrac™ from the radial (FCIrad) and femoral (FCIfem) arteries and using NICaS™ at corresponding time points (NCIrad and NCIfem). CI measurements were recorded at six time points: baseline (T1), post-induction (T2), post-sternotomy (T3), post-CPB weaning (T4), post-protamine (T5), and post-sternal closure (T6). Agreement between methods was assessed using Bland-Altman analysis, while trending ability was evaluated using four-quadrant and polar plot analyses. A ±30% change in CI relative to FloTrac™ values was considered the acceptable limit of agreement. Results: A total of 90 paired measurements were available for FCIrad-NCIrad and 73 for FCIfem-NCIfem. Bland-Altman analysis showed a bias of 0.33 L/min/m² (limits of agreement: -1.81 to 2.48 L/min/m²) for FCIrad-NCIrad and 0.52 L/min/m² (-2.03 to 3.07 L/min/m²) for FCIfem-NCIfem. Four-quadrant plots demonstrated concordance rates of 69% (radial) and 63.4% (femoral). Polar plot analysis showed angular concordance rates of 46% (radial) and 31% (femoral). Conclusion: NICaS™ showed limited agreement and trending ability compared with FloTrac™ at radial and femoral sites, indicating limited interchangeability between the two methods during cardiac surgery.
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