Comparison of cardiac output as assessed by transesophageal echo-Doppler and transpulmonary thermodilution in patients undergoing thoracic surgery
| Autor: | Christoph Ellenberger, Cidgem Inan, Marc Licker, Yann Villiger, John Robert, John Diaper, Jean-Marie Tschopp |
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| Rok vydání: | 2010 |
| Předmět: |
medicine.medical_specialty
Cardiac output Lung Neoplasms Thermodilution Cardiac index Hemodynamics Blood Pressure Heart Rate Humans Medicine In patient Prospective Studies Cardiac Output Pneumonectomy Echo doppler Aged Echocardiography Doppler Pulsed business.industry Stroke volume Middle Aged Respiration Artificial Treatment Outcome Anesthesiology and Pain Medicine Cardiothoracic surgery Anesthesia Breathing business Echocardiography Transesophageal |
| Zdroj: | Journal of Clinical Anesthesia. 22:97-103 |
| ISSN: | 0952-8180 |
| DOI: | 10.1016/j.jclinane.2009.03.013 |
| Popis: | Study Objective To evaluate the accuracy of cardiac index (CI) as measured by echo-transesophageal Doppler monitoring (echo-TDM) with CI measured by the transpulmonary thermodilution technique. Design Prospective, observational study. Setting University hospital. Patients 16 patients scheduled for elective lung cancer resection. Interventions Patients underwent two-lung ventilation (TLV) and one-lung ventilation (OLV). Measurements and Main Results CI measurements were analyzed using Bland-Altman plots. Absolute values of CI as measured by both devices were highly correlated (r 2 ranging from 0.72 to 0.77), as were relative changes in CI after the start of OLV (r 2 = 0.48, P = 0.006). Before, during, and after OLV, TDM-CI biases were 0.46 ± 0.28 L/min/m 2 , 0.25 ± 0.18 L/min/m 2 , and 0.35 ± 0.29 L/min/m 2 , respectively. Limits of agreement remained stable throughout the three measurement periods (range −1.08 to 0.21 L/min/m 2 ). The mean percentage error of CI measurements was 21.9% compared with the thermodilution technique. Although no adverse events were reported, 11% of measurement sets were incomplete due to poor signal detection. Conclusions Echo-TDM is a safe technique, allowing continuous semi-invasive assessment of hemodynamic changes in most patients undergoing open-chest surgery. Doppler-derived CI values showed significant biases and moderate clinical agreement with transpulmonary thermodilution during TLV and OLV. |
| Databáze: | OpenAIRE |
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