Reliability and benefit of estimated continuous cardiac output measurement using shunt-side SpO monitor in hemodialysis.

Introduction: Estimated continuous cardiac output (esCCO) is a novel technology that enables non-invasive and continuous monitoring of cardiac output. We compared the concordance in accuracies among esCCO measurements in the shunt limb and non-shunt limb.

Methods: In this single-center prospective observational study, we include Japanese patients who underwent dialysis at our center between April 27, 2021, and February 28, 2023. Clinical accuracy of esCCO was evaluated in the shunted and non-shunted bilateral digits. Agreement between the measurements was analyzed using Lin's congruent correlation and Bland-Altman analysis.

Results: For 43 individuals, Lin's concordance correlation coefficient was 0.9887 (95% confidence interval of 0.9886-0.9887) indicating good agreement. The values of esCCO measured in the shunt and non-shunt limbs were compatible. The percentage errors for the 43 patients with arterio-venous fistula (AVF) or arterio-venous graft (AVG), 32 with AVF, and 11 with AVG were 9.3%, 9.3%, and 8.9%, respectively.

Conclusion: esCCO could be used in shunt as well as non-shunt limbs during dialysis, allowing continuous and non-invasive hemodynamic monitoring.