TEB serves as a reliable, non-invasive tool for real-time continuous trend monitoring of CO, SV, SI, and EDV in critically ill surgical patients, with 95% limits of agreement for all four indices falling within predefined clinical acceptable thresholds despite statistically significant inter-method differences.
Key Findings
Results
Bland-Altman analysis showed a mean bias of -0.30 L/min for cardiac output (CO) between TEB and Swan-Ganz catheter measurements, with 95% limits of agreement (LOA) of -2.50 to 1.80 L/min.
42 CHD patients undergoing OPCABG were enrolled in a prospective observational study from August 2021 to March 2022
Measurements were taken at two key time points: before thoracotomy and after chest closure
Bland-Altman method was corrected for repeated measurements
The 95% LOA for CO fell within predefined clinical acceptable thresholds
Paired t-test demonstrated a statistically significant inter-method difference for CO
Results
Mean bias for stroke volume (SV) between TEB and Swan-Ganz catheter was -9.10 mL, with 95% LOA of -47.70 to 29.60 mL.
The 95% LOA for SV fell within predefined clinical acceptable thresholds
Despite clinically acceptable agreement, paired t-test showed a statistically significant difference between methods for SV
Both devices recorded measurements simultaneously throughout the surgical procedure
Results
Mean bias for stroke volume index (SI) between TEB and Swan-Ganz catheter was -5.10 mL/m², with 95% LOA of -27.10 to 16.80 mL/m².
The 95% LOA for SI fell within predefined clinical acceptable thresholds
Paired t-test demonstrated a statistically significant inter-method difference for SI
Continuous hemodynamic monitoring using both TEB and Swan-Ganz catheter was maintained throughout the surgical procedure
Results
Mean bias for end-diastolic volume (EDV) between TEB and Swan-Ganz catheter was 69.80 mL, with 95% LOA of -55.45 to 195.10 mL.
The 95% LOA for EDV fell within predefined clinical acceptable thresholds despite a numerically large mean bias
Paired t-test demonstrated a statistically significant inter-method difference for EDV
EDV showed the largest mean bias and widest LOA range of all four measured parameters
Results
All four hemodynamic indices (CO, SV, SI, EDV) measured by TEB showed 95% LOA falling within predefined clinical acceptable thresholds when compared to Swan-Ganz catheter measurements.
Bland-Altman analysis corrected for repeated measurements was used as the primary agreement method
Despite clinical agreement, paired t-test demonstrated statistically significant inter-method differences for all four parameters
The study enrolled 42 CHD patients in a prospective observational design
Both methods were applied simultaneously with continuous data collection throughout the surgical procedure
Conclusions
TEB was evaluated as a clinically applicable alternative or supplementary method for perioperative hemodynamic assessment in OPCABG patients, particularly where invasive monitoring is contraindicated.
TEB is described as a non-invasive tool for real-time continuous trend monitoring
The study specifically targets critically ill surgical patients as a population of interest
The authors support TEB as both an alternative and supplementary method, not a complete replacement for invasive monitoring
The clinical context was off-pump coronary artery bypass grafting (OPCABG) in a single hospital setting
What This Means
This research compared two methods of monitoring heart function during a type of heart bypass surgery performed without a heart-lung machine (off-pump coronary artery bypass grafting). The traditional method, using a Swan-Ganz catheter, requires inserting a tube into a major blood vessel to measure how well the heart is pumping. The newer method, thoracic electrical bioimpedance (TEB), uses sensors placed on the skin and measures changes in electrical signals through the chest to estimate heart function without any invasive procedures. The study tracked 42 patients and compared four measures of heart performance—cardiac output, stroke volume, stroke volume index, and end-diastolic volume—at two points during surgery.
The researchers found that while standard statistical tests did detect measurable differences between the two methods, the overall spread of those differences fell within ranges that were considered clinically acceptable before the study began. In other words, TEB did not produce identical numbers to the Swan-Ganz catheter, but the disagreements were small enough that they would not lead to meaningfully different clinical decisions in most cases. This suggests TEB can track trends in heart function reliably enough to be useful during surgery.
This research suggests that TEB could be a valuable non-invasive option for monitoring heart function during high-risk surgeries, especially for patients in whom inserting a Swan-Ganz catheter would pose additional risks. Rather than replacing the Swan-Ganz catheter entirely, TEB may serve as a complementary tool or an alternative when invasive monitoring is not possible or advisable. The findings are based on a relatively small group of patients at a single hospital, so larger studies would help confirm these conclusions across broader patient populations.
Wang W, Bu X, Zhang Q, Qi F, Gao H. (2026). TEB vs. Swan-Ganz catheter: hemodynamic monitoring agreement in off-pump coronary artery bypass grafting.. Annals of medicine. https://doi.org/10.1080/07853890.2026.2719250