Key result
The sitting position resulted in a higher rate of failed measurements, prolonged time to first acceptable measurement, and lower signal quality compared with supine and tilted positions.
Why the study?
Does patient position influence Doppler signal quality and acquisition time when using the USCOM1A continuous wave cardiac output monitor in healthy adults?
Observational (n=30)
Does patient position influence Doppler signal quality and acquisition time when using the USCOM1A continuous wave cardiac output monitor in healthy adults?
When using the USCOM1A monitor, the sitting position should be avoided due to difficulty in obtaining a reliable signal compared to supine or tilted positions.
Sitting position was associated with poorer USCOM1A signals in healthy adults; leaves open optimal positioning for clinical cardiac output monitoring.
In Brief BACKGROUND: The USCOM1A continuous wave cardiac output monitor (USCOM Pty Ltd., Sydney, NSW, Australia) is a novel Doppler-based device used to measure cardiac output noninvasively. The proper alignment of the transducer, and hence the ultrasound beam to the aortic or pulmonary outflow tracts, is essential to acquire accurate measurements and often much time is spent on transducer and/or patient positioning. In this prospective, observational, crossover study, we investigated the effect of patient positioning on the acquisition of cardiac output measurement with USCOM1A. METHODS: We measured cardiac output using USCOM1A in 30 healthy adult volunteers, each in five different positions: sitting, supine, Trendelenburg (20 degrees), left lateral tilt (20 degrees), and right lateral tilt (20 degrees) and compared the time required to obtain acceptable measurements. We also compared the quality of the Doppler signal obtained in these positions using a scoring system designed for this study. RESULTS: There was a higher rate of failed measurement, the mean time to obtain the first acceptable measurement was prolonged and the optimal measurement obtained within a 5-min period was of a lower quality in the sitting position compared with the other four positions. CONCLUSIONS: Our results suggested the sitting position is the least suitable and least reliable position in which to perform cardiac output measurements using USCOM1A compared with the supine, Trendelenburg (20 degrees), left lateral tilt (20 degrees), and right lateral tilt (20 degrees) positions. IMPLICATIONS: When using the USCOM1A Ultrasonic Cardiac Output Monitor to assess cardiac output, the sitting position should be avoided because it is difficult to obtain a reliable signal in this position. The supine, Trendelenburg, left lateral tilt (20 degrees), and right lateral tilt (20 degrees) positions were comparable with regards to signal acquisition and quality.
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Siu et al. (2008) conducted an observational in Healthy (n=30). Sitting position vs. Supine, Trendelenburg, left lateral tilt, and right lateral tilt positions was evaluated on Time required to obtain acceptable measurements and quality of the Doppler signal. The sitting position resulted in a higher rate of failed measurements, prolonged time to first acceptable measurement, and lower signal quality compared with supine and tilted positions.
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