Hemodynamics, fluids & transfusion
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
Authors' conclusion
The 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.
Study context
- Population
- Adult surgical or critically ill patients; clinical studies published since 2010113 data sets
- Participants
- 3,111 participants · 92 studies
- Comparison
- Pulse wave analysis vs Thermodilution
- Outcome
- Pooled percentage error, mean difference (SD) and 95% limits of agreement
Methodological detailsrandom-effects meta-analysis, subgroup analyses by patient population and test device
- Random-effects meta-analysis
- Subgroup analyses by patient population and test device
Pooled result
As reported in the abstract
Agreement of pulse wave analysis-derived CO vs reference thermodilution (pooled)
- Cardiac output (71 data sets): pooled percentage error
- 44.0% (95% CI 38.2%-49.8%)
- Cardiac output: mean difference (SD 1.3), L min-1
- −0.1
- Cardiac output: 95% limits of agreement, L min-1
- −2.6 to 2.4
- Cardiac output: I2
- 9.8%
- Cardiac index (42 data sets): pooled percentage error
- 49.1% (95% CI 40.6%-57.6%)
- Cardiac index: mean difference (SD 0.9), L min-1 m-2
- −0.1
- Cardiac index: 95% limits of agreement, L min-1 m-2
- −1.8 to 1.6
- Cardiac index: I2
- 7.9%
Further pooled results
Percentage error by patient population and device (subgroup)
- Percentage error varied substantially across patient populations and devices
Risk of bias
- Overall risk of bias was low
Original publication
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. Br J Anaesth. Published 2 June 2026. doi:10.
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