Noninvasive cardiac index estimation under general anaesthesia: comparison between the VenArt® device and transthoracic echocardiography

Sep 29, 2026

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VenArt® is a novel noninvasive cardiac output monitoring device that provides beat-by-beat stroke volume and cardiac output based on the Fick principle. A prospective observational study assessed its accuracy against cardiac index measurements obtained by transthoracic echocardiography in 55 women (ASA I–III) undergoing laparoscopic gynaecological surgery. Primary evaluation used Bland–Altman agreement for cardiac index, including bias, precision, mean percentage error, and limits of agreement, with secondary assessment of trending over time.

LanguageEnglish

CategoryResearch & Report

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Pages7

Reading Time18 min

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Abstract

Background

Methods

Results

Conclusions

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Study Rationale and Context

Open BJA Open, 17 (C): 100516 (2026) doi: 10.1016/j.bjao.2025.100516 Original Research Article |
| | | --- | --- | | Noninvasive cardiac index estimation under general anaesthesia: comparison between the VenArt® device and transthoracic echocardiography☆ | | | Catherine Paschoud1,2, Nicolas Silvestrini1, John Daniels1, Jrmie Koegel1, Stphanie Mulin1, Florence Gonzalez Ennahdi-Elidrissi1, Laszlo Vutskits1,2, Nadia Elia1,2 and
Georges L. Savoldelli1,2,*
1Division of Anaesthesiology, Department of Acute Care Medicine, Geneva University Hospitals, Geneva, Switzerland and 2Department of Anaesthesiology, Pharmacology, Intensive Care and Emergency Medicine, Faculty of Medicine, University of Geneva, Geneva, Switzerland
*Corresponding author. E-mail: [georges.savoldelli@hug.ch](georges.savoldelli@hug.ch)
☆Part of this work was presented in the form of an abstract and an oral poster presentation at the Euroanaesthesia 2025 meeting in Lisbon, 25—27 May 2025. | | | Abstract
Background: VenArt® is a novel noninvasive cardiac output monitoring device which provides beat-by-beat Fick principle-based measurements of stroke volume and cardiac output. The study aim was to determine the accuracy of this device by comparing it with cardiac output measurements using transthoracic echocardiography in patients undergoing anaesthesia.
Methods: This prospective observational study included 55 women (ASA physical status classification I—III) undergoing laparoscopic gynaecological procedures. Cardiac output was assessed at five timepoints using the VenArt® device and transthoracic echocardiography. Primary endpoint was the agreement between the two methods regarding cardiac index, evaluated using Bland—Altman analysis to determine bias, precision, mean percentage error, and limits of agreement. Secondary endpoint was the ability of the device to track changes in cardiac index over time compared with echocardiography.
Results: We analysed 273 pairs of cardiac index values from 55 patients. Bland—Altman analysis showed a bias of 0.02 (95% confidence interval [CI] 0—0.05) L min − 1 m − 2, with a precision of 0.20 and a mean percentage error of 14.7%(95% CI 13.2—16.2%) . Limits of agreement ranged from − 0.37 (95% CI − 0.41 to − 0.33) to 0.41 (95% CI 0.37—0.45) L min − 1 m − 2. Trending ability demonstrated good agreement: the four-quadrant plot revealed a concordance rate of 95.88%, and the polar plot showed a mean polar angle of 0.75◦ , with a standard deviation of 13.4◦ and radial limits of agreement within plus or minus 30◦ .
Conclusions: The VenArt® device showed negligible bias and acceptable differences. Trending ability was favourable, with clinically acceptable agreement and high concordance in tracking haemodynamic changes.
Clinical trial registration: ISRCTN92565809 .
Keywords: cardiac index; cardiac output; echocardiography; Fick principle; general anaesthesia; laparoscopy; transthoracic echocardiography; VenArt device | | | | | Received: 28 July 2025; Accepted: 18 November 2025 © 2025 The Author(s) . Published by Elsevier Ltd on behalf of British Journal of Anaesthesia. This is an open access article under the CC BY license ([http://](http://)[ ](http://)[creativecommons.org/licenses/by/4.0/](creativecommons.org/licenses/by/4.0/)) . For Permissions, please email: [permissions@elsevier.com](permissions@elsevier.com) Monitoring cardiac output (CO), a key determinant of tissue oxygen delivery and arterial blood pressure, provides us with meaningful information to guide haemodynamic management during the perioperative period.1 Although pulmonary artery catheterisation, using thermodilution or the Fick principle, is considered the gold standard for CO measurement, its invasiveness limits routine use in clinical practice.2,3 Transthoracic echocardiography (TTE) provides an appealing noninvasive alternative as this method shows acceptable accuracy and precision when compared with invasive CO meas

FAQs

What is VenArt® and what does it measure under anaesthesia?

VenArt® is a noninvasive cardiac output monitoring device that estimates beat-by-beat stroke volume and cardiac output using a Fick principle-based approach.

How was the study designed to compare VenArt® with echocardiography?

A prospective observational study measured cardiac index at five timepoints using both VenArt® and transthoracic echocardiography in 55 women undergoing laparoscopic gynaecological procedures.

What statistical method assessed agreement between the two measurement approaches?

Bland–Altman analysis was used to quantify bias, precision, mean percentage error, and limits of agreement for cardiac index, with additional trending evaluation over time.

Sep 29, 2026

Upload by Sarah