Key result
TEE descending aortic flow underestimates cardiac output by ~0.5 L/min compared to thermodilution.
Why the study?
The accuracy and reliability of cardiac output assessment by measuring descending aortic blood flow using TEE in patients undergoing cardiac surgery under CPB were uncertain.
Observational (n=22)
Single-blind
No
Mean Difference: 0.5 (95% CI 0.3–0.7)
May caution against sole reliance on descending aortic flow for cardiac output; leaves open need for validation studies.
Background To investigate the accuracy and reliability of cardiac output (CO) assessment by transesophageal echocardiographic (TEE) measuring descending aortic blood flow (DABF) in patients undergoing cardiac surgery under cardiopulmonary bypass (CPB). And the influence of DABF/CO on the accuracy and reliability of CO assessment were also analyzed. Methods Paired CO measured by both thermodilution (TCO) and Doppler method (DCO) were obtained before incision, immediately after CPB, 15 minutes after CPB, 30 minutes after CPB, 45 minutes after CPB, and at the end of surgery. The DCO was converted from TEE measured DABF using theoretical proportion (70%) of DABF/CO. Regression analysis, Bland-Altman graph, and Polar plot were used to analyze the correlation and agreement between the CO measurements by the two methods. Parameters were compared by one-way ANOVA among different time points. Results A total of 132 pairs of CO measurements were obtained from 22 patients. The average proportion of DABF/TCO ranged from 54% before CPB to 63% after CBP. A good correlation between DCO and TCO (r = 0.81) was found. The Bland-Altman analysis showed a large positive bias between the TCO and DCO. The Polar plot also showed a poor concordance between changes of DCO and TCO. The proportion of DABF/TCO had a mild negative correlation with systemic vascular resistance index (SVRI) but not with cardiac output index (CI). Conclusions The CO, converted from TEE measured DABF, was underestimated in patients undergoing cardiac surgery. The varied proportion between DABF and CO mainly influenced the accuracy and reliability of CO assessment. Trial registration: Chinese Clinical Trials Register Identifier: ChiCTR-OCS-12002789 (retrospective registered). Date: 2012.12.21
No takes yet. Share an insight, caveat, or question.
Peng et al. (2021) conducted an observational in Patients undergoing elective cardiac surgery under cardiopulmonary bypass (n=22). Cardiac output assessment by transesophageal echocardiography measuring descending aortic blood flow (DCO) vs. Bolus thermodilution cardiac output assessment (TCO) was evaluated on Agreement between thermodilution (TCO) and Doppler method (DCO) (Mean bias 0.5 L/min, 95% CI 0.3-0.7). Transesophageal echocardiography measurement of descending aortic blood flow underestimated cardiac output with a mean bias of 0.5 L/min compared to thermodilution.
Synapse has enriched 5 closely related papers on similar clinical questions. Consider them for comparative context: