Transesophageal Doppler cardiac output monitoring: performance during aortic reconstructive surgery.

Abstract:

:Transesophageal Doppler (TED) monitoring provides continuous, noninvasive monitoring of cardiac output by measurement of aortic flow velocities. Because of the effects on aortic flow dynamics resulting from atherosclerosis, aortic cross-clamping, and wide variations in arterial blood pressure, the validity of TED monitoring during aortic surgery is unresolved. The authors prospectively evaluated a second-generation TED cardiac output monitor in 42 patients undergoing aortic reconstructive surgery. Four hundred eighty-nine simultaneous measurements of TED and thermodilution cardiac output were obtained. Transesophageal Doppler measurements were highly correlated to thermodilution measurements (R = 0.94); however, Bland-Altman analysis revealed a moderate error in the TED measurements (2 SD of the bias = 1.4 L/min). Trending analysis showed that TED monitoring accurately tracked changes in thermodilution cardiac output. Placement of an aortic cross-clamp resulted in significant reductions in the accuracy of Doppler measurements. Arterial blood pressure variations did not systematically affect the accuracy of the transesophageal technique. Limitations of TED monitoring, including a difficult calibration procedure, poor performance during aortic cross-clamping, and the need for probe repositioning, suggest further development is warranted.

journal_name

Anesth Analg

journal_title

Anesthesia and analgesia

authors

Perrino AC Jr,Fleming J,LaMantia KR

doi

10.1213/00000539-199112000-00006

subject

Has Abstract

pub_date

1991-12-01 00:00:00

pages

705-10

issue

6

eissn

0003-2999

issn

1526-7598

journal_volume

73

pub_type

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