Two- or 3-Dimensional Echocardiography-Derived Cardiac Output Cannot Replace the Pulmonary Artery Catheter in Cardiac Surgery
| Autor: | Kane O. Pryor, Elizabeth Mauer, Mario Gaudino, Mudit Kaushal, Lisa Q. Rong, Meaghan Kenfield, Peter J. Neuburger, Linda Shore-Lesseron |
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| Rok vydání: | 2020 |
| Předmět: |
Cardiac output
medicine.medical_specialty Catheters medicine.medical_treatment Thermodilution Echocardiography Three-Dimensional 030204 cardiovascular system & hematology Pulmonary Artery law.invention 03 medical and health sciences 0302 clinical medicine 030202 anesthesiology law Internal medicine medicine.artery medicine Cardiopulmonary bypass Humans Cardiac Output Cardiac Surgical Procedures 3 dimensional echocardiography business.industry Limits of agreement Pulmonary artery catheter Cardiac surgery surgical procedures operative Anesthesiology and Pain Medicine Pulmonary artery Cardiology Left ventricular outflow tract area Cardiology and Cardiovascular Medicine business Echocardiography Transesophageal |
| Zdroj: | Journal of cardiothoracic and vascular anesthesia. 34(10) |
| ISSN: | 1532-8422 |
| Popis: | Objectives: Three-dimensional (3D) transesophageal echocardiography (TEE) has been shown to be more accurate than 2D TEE for the evaluation of the left ventricular outflow tract area. The aim of the present study was to compare the agreement of 3D echocardiography–derived cardiac output (CO) with thermodilution-derived CO (TDCO) before and after cardiopulmonary bypass (CPB). Design This was a prospective observational study of patients who underwent cardiac surgery between 2016 and 2018. Setting Weill Cornell Medicine, a single large academic medical center. Participants The study comprised 78 patients undergoing elective cardiac surgery. Interventions CPB, TEE, pulmonary artery catheter, and elective cardiac surgery. Measurements and Main Results Two-dimensional CO, 3D CO-diameter, and 3D CO-area values pre-CPB were strongly correlated with one another both pre-CPB and post-CPB. The 3D CO-diameter and the 3D CO-area were mildly correlated, with TDCO measurements pre-CPB (r = 0.46 and 0.39, respectively) and post-CBP (r = 0.43 and 0.47, respectively). Pre-CPB 3D CO-diameter had the most agreement with TDCO in terms of bias (–0.13 L/min); however, the limits of agreement (LOA) were wide (–2.2- to- 2.45 L/min). Post-CPB, 3D CO-diameter had the most agreement with TDCO in terms of bias (0.41) but with wide LOA (–3.29 to 2.47). All pre-CPB echocardiography–derived CO (2D CO, 3D CO-diameter, 3D CO-area) had more agreement with TDCO than did post-CPB measurements. Conclusions Three-dimensional CO measurements were only modestly correlated with pulmonary artery catheter–derived CO pre-bypass and post-bypass. Despite low bias, the wide LOA from 2D CO, 3D CO-diameter, and 3D-area compared with TDCO suggested that the 2 methods are not interchangeable. |
| Databáze: | OpenAIRE |
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