November 29, 2025
Background: Cardiac output can be estimated noninvasively using electrical cardiometry with the ICON® monitor (Osypka Medical GmbH, Berlin, Germany). Conflicting results have been reported regarding the accuracy of electrical cardiometry. This prospective method comparison study evaluated the performance of electrical cardiometry-derived cardiac output (EC-CO) against intermittent pulmonary artery thermodilution-derived cardiac output (PATD-CO) in patients after coronary artery bypass graft (CABG) surgery.
Methods: Cardiac output measured using electrical cardiometry (EC-CO; test method) was compared with cardiac output measured using intermittent pulmonary artery thermodilution (PATD-CO; reference method). Agreement between methods was assessed using Bland-Altman analysis to calculate the mean difference with 95% limits of agreement (95% LOA) and corresponding 95% confidence intervals (95% CI). Percentage error was also calculated, and trending ability was evaluated using four-quadrant plot analysis.
Results: A total of 157 paired cardiac output measurements from 41 patients were analyzed. Mean ± standard deviation PATD-CO was 5.1 ± 1.3 L/min, and mean EC-CO was 5.3 ± 1.3 L/min. The mean difference between PATD-CO and EC-CO was -0.2 (95% CI -0.5 to 0.2) ± 1.2 L/min, with a lower 95% LOA of -2.6 (95% CI -3.1 to -2.0) L/min and an upper 95% LOA of 2.3 (95% CI 1.6 to 2.9) L/min. The percentage error was 47% (95% CI, 37% to 56%). The concordance rate for cardiac output changes was 48%.
Conclusions: In patients undergoing CABG surgery, agreement between EC-CO and PATD-CO was not clinically acceptable. Electrical cardiometry also demonstrated poor trending ability for monitoring changes in cardiac output.
Keywords: pulmonary artery catheter; pulmonary artery thermodilution; hemodynamic monitoring; thoracic electrical bioimpedance; electrical cardiometry; cardiac output.
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