The Experts below are selected from a list of 360 Experts worldwide ranked by ideXlab platform
Paolo Pietropaoli - One of the best experts on this subject based on the ideXlab platform.
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continuous and intermittent cardiac output measurement in hyperdynamic conditions Pulmonary Artery Catheter vs lithium dilution technique
Intensive Care Medicine, 2008Co-Authors: M G Costa, P. Chiarandini, Silvia Mattelig, Livia Pompei, Mauricio Sainz Barriga, Toby Reynolds, Giorgio Della Rocca, Maurizio Cecconi, Paolo PietropaoliAbstract:Objective: This study aimed to assess the level of agreement of both intermittent cardiac output monitoring by the lithium dilution technique (COLi) and continuous car- diac output monitoring (PulseCOLi) using the arterial pressure waveform with intermittent thermodilution using a Pulmonary Artery Catheter (COPAC). Design: Prospective, single-center evaluation. Setting: University Hospital Intensive Care Unit. Patients: Patients (n=23) receiving liver transplantation. Inter- vention: Pulmonary Artery Catheters were placed in all patients and COPAC was determined using thermodilution. COLi and PulseCOLi measurements were made using the LiDCO system. Measurementsand main results: Data were collected after intensive care unit admission and every 8 h until the 48th hour. A total of 151 COPAC, COLi and PulseCOLi measurements were analysed. Bias and 95% limit of agreement were 0.11lmin -1 and -1.84 to + 2.05lmin -1 for COPAC vs. COLi (r = 0.88) resulting in an overall percentage error of 15.6%. Bias and 95% limit of agreement for COPAC vs. PulseCOLi were 0.29lmin -1 and -1.87 to + 2.46lmin -1 (r = 0.85) with
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continuous and intermittent cardiac output measurement in hyperdynamic conditions Pulmonary Artery Catheter vs lithium dilution technique
Intensive Care Medicine, 2008Co-Authors: M G Costa, P. Chiarandini, Silvia Mattelig, Livia Pompei, Mauricio Sainz Barriga, Toby Reynolds, Giorgio Della Rocca, Maurizio Cecconi, Paolo PietropaoliAbstract:This study aimed to assess the level of agreement of both intermittent cardiac output monitoring by the lithium dilution technique (COLi) and continuous cardiac output monitoring (PulseCOLi) using the arterial pressure waveform with intermittent thermodilution using a Pulmonary Artery Catheter (COPAC). Prospective, single-center evaluation. University Hospital Intensive Care Unit. Patients (n = 23) receiving liver transplantation. Pulmonary Artery Catheters were placed in all patients and COPAC was determined using thermodilution. COLi and PulseCOLi measurements were made using the LiDCO system. Data were collected after intensive care unit admission and every 8 h until the 48th hour. A total of 151 COPAC, COLi and PulseCOLi measurements were analysed. Bias and 95% limit of agreement were 0.11 lmin–1 and –1.84 to + 2.05 lmin–1 for COPAC vs. COLi (r = 0.88) resulting in an overall percentage error of 15.6%. Bias and 95% limit of agreement for COPAC vs. PulseCOLi were 0.29 lmin–1 and –1.87 to + 2.46 lmin–1 (r = 0.85) with a percentage error of 16.8%. Subgroup analysis revealed a percentage error of 15.7% for COPAC vs. COLi and 15.1% for COPAC vs. PulseCOLi for data pairs less than 8 lmin–1, and percentage errors of 15.5% and 18.5% respectively for data pairs higher than 8 lmin–1. In patients with hyperdynamic circulation, intermittent and continuous CO values determined using the LiDCO system showed good agreement with those obtained by intermittent Pulmonary Artery thermodilution.
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preload and haemodynamic assessment during liver transplantation a comparison between the Pulmonary Artery Catheter and transPulmonary indicator dilution techniques
European Journal of Anaesthesiology, 2002Co-Authors: G Della Rocca, M G Costa, C Coccia, L Pompei, Paolo PietropaoliAbstract:Background and objective: Liver transplantation is characterized by several changes in intravascular blood volume due to vasodilatation based on neurohumoral mediators, intraoperative bleeding and anaesthesia technique effects. Today, with the transPulmonary indicator dilution technique, cardiac index (CIart) can be evaluated and preload assessed in terms of the intrathoracic blood volume index (ITBVI). The aim was to analyse in patients undergoing liver transplantation two preload variables, Pulmonary Artery occlusion pressure (PAOP) and ITBVI with respect to cardiac index (CIpa) and stroke volume index (SVIpa), the correlation between ITBVI and PAOP, and secondary the relationship between the changes (A) of ITBVI and PAOP and the changes of CIpa and SVIpa, and the relationships between ΔITBVI and ΔPAOP. The reproducibility and precision of all Clart and CIpa measurements were also evaluated. Methods: A prospective study was performed in 60 patients monitored with a Pulmonary Artery Catheter and with the PiCCO® system. The variables were evaluated with a linear regression model. Results: Linear regression analysis between ITBVI-Clpa and ITBVI-SVIpa were r 2 = 0.47 (P < 0.0001) and r 2 = 0.55 (P < 0.0001) respectively, while PAOP poorly correlated to CIpa (r 2 = 0.02), SVIpa (r 2 = 0.015) and ITBVI (r 2 = 0.002). Only changes in ITBVI were correlated with changes in CIpa (Δ 1 , r 2 = 0.37; Δ 2 , r 2 = 0.32), and SVIpa (Δ 1 , r 2 = 0.60; Δ 2 , r 2 = 0.47). The mean bias between CIart and CIpa was 0.13 L min -1 m -2 (2 SD = 1.04L min -1 m -2 ) (r 2 = 0.86, P < 0.0001). Conclusions: In comparison with PAOP, ITBVI seems a more reliable indicator of cardiac preload in patients undergoing liver transplantation.
Michael G Irwin - One of the best experts on this subject based on the ideXlab platform.
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comparison of the uscom ultrasound cardiac output monitor with Pulmonary Artery Catheter thermodilution in patients undergoing liver transplantation
Liver Transplantation, 2008Co-Authors: Laisze Grace Wong, Boonhun Yong, Karl Young, Kinglik Cheng, Michael G IrwinAbstract:The aim of the study was to compare the standard technique of cardiac output determination by Pulmonary Artery Catheter thermodilution (PAC-TD) with a noninvasive ultrasound Doppler monitor (USCOM Pty., Ltd., Coffs Harbour, Australia) in surgery for liver transplantation. We wished to determine if the degree of accuracy would allow the ultrasound cardiac output monitor (USCOM) to be used as an alternative monitor in a clinical setting in which wide fluctuations in cardiac output could be expected. This was a prospective method comparison study, with 71 paired measurements obtained in 12 patients undergoing liver transplantation in a university teaching hospital. Bland-Altman analysis of the 2 techniques showed a bias of 0.39 L/minute, with the USCOM cardiac output lower compared with that of PAC-TD. The bias was small and did not vary with the magnitude of the cardiac output. The 95% limits of agreement were −1.47 and 2.25 L/minute. There was good repeatability for USCOM measurements, with a repeatability coefficient of 0.43 for USCOM versus 0.77 for PAC-TD. We conclude that USCOM is acceptable for the clinical determination of noninvasive cardiac output, particularly in situations in which tracking changes over time is more important than knowing the precise value. However, the utility of USCOM is limited by its inability to measure Pulmonary Artery pressure. Liver Transpl 14:1038–1043, 2008. © 2008 AASLD.
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comparison of the uscom ultrasound cardiac output monitor with Pulmonary Artery Catheter thermodilution in patients undergoing liver transplantation
Liver Transplantation, 2008Co-Authors: Laisze Grace Wong, Boonhun Yong, Karl Young, Kinglik Cheng, Leesung Lau, Jeff Siufan Man, Michael G IrwinAbstract:The aim of the study was to compare the standard technique of cardiac output determination by Pulmonary Artery Catheter thermodilution (PAC-TD) with a noninvasive ultrasound Doppler monitor (USCOM Pty., Ltd., Coffs Harbour, Australia) in surgery for liver transplantation. We wished to determine if the degree of accuracy would allow the ultrasound cardiac output monitor (USCOM) to be used as an alternative monitor in a clinical setting in which wide fluctuations in cardiac output could be expected. This was a prospective method comparison study, with 71 paired measurements obtained in 12 patients undergoing liver transplantation in a university teaching hospital. Bland-Altman analysis of the 2 techniques showed a bias of 0.39 L/minute, with the USCOM cardiac output lower compared with that of PAC-TD. The bias was small and did not vary with the magnitude of the cardiac output. The 95% limits of agreement were -1.47 and 2.25 L/minute. There was good repeatability for USCOM measurements, with a repeatability coefficient of 0.43 for USCOM versus 0.77 for PAC-TD. We conclude that USCOM is acceptable for the clinical determination of noninvasive cardiac output, particularly in situations in which tracking changes over time is more important than knowing the precise value. However, the utility of USCOM is limited by its inability to measure Pulmonary Artery pressure.
M. J. West - One of the best experts on this subject based on the ideXlab platform.
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Pulmonary Artery Catheter pac accuracy and efficacy compared with flow probe and transcutaneous doppler uscom an ovine cardiac output validation
Critical Care Research and Practice, 2012Co-Authors: Robert A Phillips, Sally G Hood, Beverley M Jacobson, M. J. WestAbstract:Background. The Pulmonary Artery Catheter (PAC) is an accepted clinical method of measuring cardiac output (CO) despite no prior validation. The ultrasonic cardiac output monitor (USCOM) is a noninvasive alternative to PAC using Doppler ultrasound (CW). We compared PAC and USCOM CO measurements against a gold standard, the aortic flow probe (FP), in sheep at varying outputs. Methods. Ten conscious sheep, with implanted FPs, had measurements of CO by FP, USCOM, and PAC, at rest and during intervention with inotropes and vasopressors. Results. CO measurements by FP, PAC, and USCOM were 4.0±1.2 L/min, 4.8±1.5 L/min, and 4.0±1.4 L/min, respectively, (
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Pulmonary Artery Catheter pac accuracy and efficacy compared with flow probe and transcutaneous doppler uscom an ovine cardiac output validation
Critical Care Research and Practice, 2012Co-Authors: Robert A Phillips, Sally G Hood, Beverley M Jacobson, M. J. WestAbstract:Background. The Pulmonary Artery Catheter (PAC) is an accepted clinical method of measuring cardiac output (CO) despite no prior validation. The ultrasonic cardiac output monitor (USCOM) is a noninvasive alternative to PAC using Doppler ultrasound (CW). We compared PAC and USCOM CO measurements against a gold standard, the aortic flow probe (FP), in sheep at varying outputs. Methods. Ten conscious sheep, with implanted FPs, had measurements of CO by FP, USCOM, and PAC, at rest and during intervention with inotropes and vasopressors. Results. CO measurements by FP, PAC, and USCOM were 4.0±1.2 L/min, 4.8±1.5 L/min, and 4.0±1.4 L/min, respectively, (
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Pulmonary Artery Catheter pac accuracy and efficacy compared with flow probe and transcutaneous doppler uscom an ovine cardiac output validation
Critical Care Research and Practice, 2012Co-Authors: Robert A Phillips, Sally G Hood, Beverley M Jacobson, M. J. West, Li Wan, Clive N MayAbstract:Background. The Pulmonary Artery Catheter (PAC) is an accepted clinical method of measuring cardiac output (CO) despite no prior validation. The ultrasonic cardiac output monitor (USCOM) is a noninvasive alternative to PAC using Doppler ultrasound (CW). We compared PAC and USCOM CO measurements against a gold standard, the aortic flow probe (FP), in sheep at varying outputs. Methods. Ten conscious sheep, with implanted FPs, had measurements of CO by FP, USCOM, and PAC, at rest and during intervention with inotropes and vasopressors. Results. CO measurements by FP, PAC, and USCOM were 4.0 ± 1.2 L/min, 4.8 ± 1.5 L/min, and 4.0 ± 1.4 L/min, respectively, (n = 280, range 1.9 L/min to 11.7 L/min). Percentage bias and precision between FP and PAC, and FP and USCOM was -17 and 47%, and 1 and 36%, respectively. PAC under-measured Dobutamine-induced CO changes by 20% (relative 66%) compared with FP, while USCOM measures varied from FP by 3% (relative 10%). PAC reliably detected -30% but not +40% CO changes, as measured by receiver operating characteristic area under the curve (AUC), while USCOM reliably detected ±5% changes in CO (AUC > 0.70). Conclusions. PAC demonstrated poor accuracy and sensitivity as a measure of CO. USCOM provided equivalent measurements to FP across a sixfold range of outputs, reliably detecting ±5% changes.
M G Costa - One of the best experts on this subject based on the ideXlab platform.
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uncalibrated continuous cardiac output measurement in liver transplant patients lidcorapid system versus Pulmonary Artery Catheter
Journal of Cardiothoracic and Vascular Anesthesia, 2014Co-Authors: M G Costa, P. Chiarandini, Livia Pompei, Luigia Scudeller, Luigi Vetrugno, Giovanni Serena, S Buttera, Giorgio Della RoccaAbstract:Objective The aim of the study was to assess the level of agreement between continuous cardiac output estimated by uncalibrated pulse-power analysis (PulseCOLiR) and intermittent (ICO) and continuous cardiac output (CCO) obtained using a Pulmonary Artery Catheter (PAC). Design Prospective cohort study. Setting University hospital intensive care unit. Participants Twenty patients after liver transplantation. Intervention Pulmonary Artery Catheters were placed in all patients, and ICO and CCO were determined using thermodilution. PulseCOLiR measurements were made using a LiDCOrapidTM (LiDCO Ltd, Cambridge, UK). Measurements and Main Results ICO data were determined after intensive care unit admission and every 8 hours until the 48th postoperative hour. CCO and PulseCOLiR measurements were recorded simultaneously at these same time intervals as well as hourly. For the 8-hour data set (140 data pairs), the mean bias and percentage errors (PE) were, respectively,−0.10 L/min and 39.2% for ICO versus PulseCOLiR and 0.79 L/min and 34.6% for CCO versus PulseCOLiR. For the hourly comparison of CCO versus PulseCOLiR (980 data pairs), the bias was 0.75 L/min and the PE 37%. To assess the ability to measure change, a 4-quadrant plot was produced for each pair of methods. The performance of PulseCOLiR was moderate in detecting changes in ICO. Conclusions In conclusion, the uncalibrated PulseCOLir method should not be used as a substitute for the thermodilution technique for the monitoring of cardiac output in liver transplant patients.
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continuous and intermittent cardiac output measurement in hyperdynamic conditions Pulmonary Artery Catheter vs lithium dilution technique
Intensive Care Medicine, 2008Co-Authors: M G Costa, P. Chiarandini, Silvia Mattelig, Livia Pompei, Mauricio Sainz Barriga, Toby Reynolds, Giorgio Della Rocca, Maurizio Cecconi, Paolo PietropaoliAbstract:Objective: This study aimed to assess the level of agreement of both intermittent cardiac output monitoring by the lithium dilution technique (COLi) and continuous car- diac output monitoring (PulseCOLi) using the arterial pressure waveform with intermittent thermodilution using a Pulmonary Artery Catheter (COPAC). Design: Prospective, single-center evaluation. Setting: University Hospital Intensive Care Unit. Patients: Patients (n=23) receiving liver transplantation. Inter- vention: Pulmonary Artery Catheters were placed in all patients and COPAC was determined using thermodilution. COLi and PulseCOLi measurements were made using the LiDCO system. Measurementsand main results: Data were collected after intensive care unit admission and every 8 h until the 48th hour. A total of 151 COPAC, COLi and PulseCOLi measurements were analysed. Bias and 95% limit of agreement were 0.11lmin -1 and -1.84 to + 2.05lmin -1 for COPAC vs. COLi (r = 0.88) resulting in an overall percentage error of 15.6%. Bias and 95% limit of agreement for COPAC vs. PulseCOLi were 0.29lmin -1 and -1.87 to + 2.46lmin -1 (r = 0.85) with
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continuous and intermittent cardiac output measurement in hyperdynamic conditions Pulmonary Artery Catheter vs lithium dilution technique
Intensive Care Medicine, 2008Co-Authors: M G Costa, P. Chiarandini, Silvia Mattelig, Livia Pompei, Mauricio Sainz Barriga, Toby Reynolds, Giorgio Della Rocca, Maurizio Cecconi, Paolo PietropaoliAbstract:This study aimed to assess the level of agreement of both intermittent cardiac output monitoring by the lithium dilution technique (COLi) and continuous cardiac output monitoring (PulseCOLi) using the arterial pressure waveform with intermittent thermodilution using a Pulmonary Artery Catheter (COPAC). Prospective, single-center evaluation. University Hospital Intensive Care Unit. Patients (n = 23) receiving liver transplantation. Pulmonary Artery Catheters were placed in all patients and COPAC was determined using thermodilution. COLi and PulseCOLi measurements were made using the LiDCO system. Data were collected after intensive care unit admission and every 8 h until the 48th hour. A total of 151 COPAC, COLi and PulseCOLi measurements were analysed. Bias and 95% limit of agreement were 0.11 lmin–1 and –1.84 to + 2.05 lmin–1 for COPAC vs. COLi (r = 0.88) resulting in an overall percentage error of 15.6%. Bias and 95% limit of agreement for COPAC vs. PulseCOLi were 0.29 lmin–1 and –1.87 to + 2.46 lmin–1 (r = 0.85) with a percentage error of 16.8%. Subgroup analysis revealed a percentage error of 15.7% for COPAC vs. COLi and 15.1% for COPAC vs. PulseCOLi for data pairs less than 8 lmin–1, and percentage errors of 15.5% and 18.5% respectively for data pairs higher than 8 lmin–1. In patients with hyperdynamic circulation, intermittent and continuous CO values determined using the LiDCO system showed good agreement with those obtained by intermittent Pulmonary Artery thermodilution.
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preload and haemodynamic assessment during liver transplantation a comparison between the Pulmonary Artery Catheter and transPulmonary indicator dilution techniques
European Journal of Anaesthesiology, 2002Co-Authors: G Della Rocca, M G Costa, C Coccia, L Pompei, Paolo PietropaoliAbstract:Background and objective: Liver transplantation is characterized by several changes in intravascular blood volume due to vasodilatation based on neurohumoral mediators, intraoperative bleeding and anaesthesia technique effects. Today, with the transPulmonary indicator dilution technique, cardiac index (CIart) can be evaluated and preload assessed in terms of the intrathoracic blood volume index (ITBVI). The aim was to analyse in patients undergoing liver transplantation two preload variables, Pulmonary Artery occlusion pressure (PAOP) and ITBVI with respect to cardiac index (CIpa) and stroke volume index (SVIpa), the correlation between ITBVI and PAOP, and secondary the relationship between the changes (A) of ITBVI and PAOP and the changes of CIpa and SVIpa, and the relationships between ΔITBVI and ΔPAOP. The reproducibility and precision of all Clart and CIpa measurements were also evaluated. Methods: A prospective study was performed in 60 patients monitored with a Pulmonary Artery Catheter and with the PiCCO® system. The variables were evaluated with a linear regression model. Results: Linear regression analysis between ITBVI-Clpa and ITBVI-SVIpa were r 2 = 0.47 (P < 0.0001) and r 2 = 0.55 (P < 0.0001) respectively, while PAOP poorly correlated to CIpa (r 2 = 0.02), SVIpa (r 2 = 0.015) and ITBVI (r 2 = 0.002). Only changes in ITBVI were correlated with changes in CIpa (Δ 1 , r 2 = 0.37; Δ 2 , r 2 = 0.32), and SVIpa (Δ 1 , r 2 = 0.60; Δ 2 , r 2 = 0.47). The mean bias between CIart and CIpa was 0.13 L min -1 m -2 (2 SD = 1.04L min -1 m -2 ) (r 2 = 0.86, P < 0.0001). Conclusions: In comparison with PAOP, ITBVI seems a more reliable indicator of cardiac preload in patients undergoing liver transplantation.
Robert A Phillips - One of the best experts on this subject based on the ideXlab platform.
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Pulmonary Artery Catheter pac accuracy and efficacy compared with flow probe and transcutaneous doppler uscom an ovine cardiac output validation
Critical Care Research and Practice, 2012Co-Authors: Robert A Phillips, Sally G Hood, Beverley M Jacobson, M. J. WestAbstract:Background. The Pulmonary Artery Catheter (PAC) is an accepted clinical method of measuring cardiac output (CO) despite no prior validation. The ultrasonic cardiac output monitor (USCOM) is a noninvasive alternative to PAC using Doppler ultrasound (CW). We compared PAC and USCOM CO measurements against a gold standard, the aortic flow probe (FP), in sheep at varying outputs. Methods. Ten conscious sheep, with implanted FPs, had measurements of CO by FP, USCOM, and PAC, at rest and during intervention with inotropes and vasopressors. Results. CO measurements by FP, PAC, and USCOM were 4.0±1.2 L/min, 4.8±1.5 L/min, and 4.0±1.4 L/min, respectively, (
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Pulmonary Artery Catheter pac accuracy and efficacy compared with flow probe and transcutaneous doppler uscom an ovine cardiac output validation
Critical Care Research and Practice, 2012Co-Authors: Robert A Phillips, Sally G Hood, Beverley M Jacobson, M. J. WestAbstract:Background. The Pulmonary Artery Catheter (PAC) is an accepted clinical method of measuring cardiac output (CO) despite no prior validation. The ultrasonic cardiac output monitor (USCOM) is a noninvasive alternative to PAC using Doppler ultrasound (CW). We compared PAC and USCOM CO measurements against a gold standard, the aortic flow probe (FP), in sheep at varying outputs. Methods. Ten conscious sheep, with implanted FPs, had measurements of CO by FP, USCOM, and PAC, at rest and during intervention with inotropes and vasopressors. Results. CO measurements by FP, PAC, and USCOM were 4.0±1.2 L/min, 4.8±1.5 L/min, and 4.0±1.4 L/min, respectively, (
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Pulmonary Artery Catheter pac accuracy and efficacy compared with flow probe and transcutaneous doppler uscom an ovine cardiac output validation
Critical Care Research and Practice, 2012Co-Authors: Robert A Phillips, Sally G Hood, Beverley M Jacobson, M. J. West, Li Wan, Clive N MayAbstract:Background. The Pulmonary Artery Catheter (PAC) is an accepted clinical method of measuring cardiac output (CO) despite no prior validation. The ultrasonic cardiac output monitor (USCOM) is a noninvasive alternative to PAC using Doppler ultrasound (CW). We compared PAC and USCOM CO measurements against a gold standard, the aortic flow probe (FP), in sheep at varying outputs. Methods. Ten conscious sheep, with implanted FPs, had measurements of CO by FP, USCOM, and PAC, at rest and during intervention with inotropes and vasopressors. Results. CO measurements by FP, PAC, and USCOM were 4.0 ± 1.2 L/min, 4.8 ± 1.5 L/min, and 4.0 ± 1.4 L/min, respectively, (n = 280, range 1.9 L/min to 11.7 L/min). Percentage bias and precision between FP and PAC, and FP and USCOM was -17 and 47%, and 1 and 36%, respectively. PAC under-measured Dobutamine-induced CO changes by 20% (relative 66%) compared with FP, while USCOM measures varied from FP by 3% (relative 10%). PAC reliably detected -30% but not +40% CO changes, as measured by receiver operating characteristic area under the curve (AUC), while USCOM reliably detected ±5% changes in CO (AUC > 0.70). Conclusions. PAC demonstrated poor accuracy and sensitivity as a measure of CO. USCOM provided equivalent measurements to FP across a sixfold range of outputs, reliably detecting ±5% changes.
