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July 1, 1998American Journal of Respiratory and Critical Care Medicine

Noninvasive Monitoring of Cardiac Output in Critically Ill Patients Using Transesophageal Doppler

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Why the study?

Does transesophageal Doppler provide a valid estimate of cardiac output compared to thermodilution in critically ill, mechanically ventilated patients?

Population

n=46 critically ill, mechanically ventilated patients from three different intensive care units

Comparison

Transesophageal Doppler for cardiac output… vs Thermodilution technique for cardiac output…

Design

Cross-sectional

Authors

BVB. ValtierPfizer (France)BCBernard CholleyHeart Failure & TransplantJBJean-Pierre BelotHôpital Louis-Mourier

Discussion

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Implication

May support transesophageal Doppler for CO monitoring in ventilated ICU patients; leaves open prospective outcome validation.

Key Points

  • To evaluate the validity and accuracy of transesophageal Doppler for measuring cardiac output compared with standard thermodilution in mechanically ventilated, critically ill patients.
  • Obtained 136 paired cardiac output measurements comparing thermodilution to transesophageal Doppler in 46 mechanically ventilated patients across three intensive care units.
  • Concurrently measured cardiac output using suprasternal Doppler and indirect calorimetry via the Fick principle in a subset of 26 patients at one center.
  • Transesophageal Doppler correlated strongly with thermodilution (r = 0.95) with a slight underestimation bias of 0.24 L/min and limits of agreement spanning -1.5 to +2.0 L/min.
  • Tracking consecutive measurement changes demonstrated identical directional trends and magnitude, with a bias of 0 L/min and limits of agreement of ±1.7 L/min.
  • Suprasternal Doppler and indirect calorimetry produced comparable correlations and levels of agreement in the tested 26-patient subgroup.

Structured PICO

Does transesophageal Doppler provide a valid estimate of cardiac output compared to thermodilution in critically ill, mechanically ventilated patients?

P
Population
n=46 critically ill, mechanically ventilated patients from three different intensive care units
I
Intervention
Transesophageal Doppler for cardiac output measurement
C
Comparator
Thermodilution technique for cardiac output measurement
O
Outcome
Correlation and agreement between cardiac output measurements using transesophageal Doppler and thermodilutionsurrogate

Transesophageal Doppler provides a valid, noninvasive alternative to thermodilution for estimating cardiac output in critically ill, mechanically ventilated patients.

Cite This Study

Valtier et al. (1998) studied this question.

synapsesocial.com/papers/6a70812cfe4101aa97e032bchttps://doi.org/10.1164/ajrccm.158.1.9707031
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Also Consider

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