A comparison of the non-invasive ultrasonic cardiac output monitor (USCOM) with the oesophageal Doppler monitor during major abdominal surgery.

Autor: Hodgson LE; Anaesthetics & Intensive Care Department, Western Sussex NHS Foundation Trust, Worthing, UK., Forni LG; Intensive Care Department, The Royal Surrey County Hospital NHS Foundation Trust, Guildford, UK; Faculty of Health and Medical Sciences, University of Surrey, Guildford, UK., Venn R; Anaesthetics & Intensive Care Department, Western Sussex NHS Foundation Trust, Worthing, UK., Samuels TL; Intensive Care Department, The Royal Surrey County Hospital NHS Foundation Trust, Guildford, UK; Faculty of Health and Medical Sciences, University of Surrey, Guildford, UK., Wakeling HG; Anaesthetics & Intensive Care Department, Western Sussex NHS Foundation Trust, Worthing, UK.
Jazyk: angličtina
Zdroj: Journal of the Intensive Care Society [J Intensive Care Soc] 2016 May; Vol. 17 (2), pp. 103-110. Date of Electronic Publication: 2015 Oct 14.
DOI: 10.1177/1751143715610785
Abstrakt: Background: Perioperative interventions, targeted to increase global blood flow defined by explicit measured goals, reduce postoperative complications. Consequently, reliable non-invasive estimation of the cardiac output could have far-reaching benefit.
Methods: This study compared a non-invasive Doppler device - the ultrasonic cardiac output monitor (USCOM) - with the oesophageal Doppler monitor (ODM), on 25 patients during major abdominal surgery. Stroke volume was determined by USCOM (SV USCOM ) and ODM (SV ODM ) pre and post fluid challenges.
Results: A ≥ 10% change (Δ) SV USCOM had a sensitivity of 94% and specificity of 88% to detect a ≥ 10% Δ SV ODM ; the area under the receiver operating curve was 0.94 (95% CI 0.90-0.99). Concordance was 98%, using an exclusion zone of <10% Δ SV ODM . 135 measurements gave median SV USCOM 80 ml (interquartile range 65-93 ml) and SV ODM 86 ml (69-100 ml); mean bias was 5.9 ml (limits of agreement -20 to +30 ml) and percentage error 30%.
Conclusions: Following fluid challenges SV USCOM showed good concordance and accurately discriminated a change ≥10% in SV ODM .
Databáze: MEDLINE
Externí odkaz: