On-line estimation of left ventricular stroke volume using transoesophageal echocardiography and acoustic quantification.
We have examined the usefulness of transoesophageal echocardiography (TOE) and automated endocardium detection for on-line calculation of left ventricular stroke volume. In 12 of 15 patients undergoing abdominal surgery, stroke volume was derived continuously from the multiple discs (MD) and area-length (AL) methods and compared with stroke volume calculated by thermodilution. In 10 patients (80%), more than three manipulations of the ultrasound transducer were required before measurements. Linear regression analysis of automated TOE methods and thermodilution revealed weak correlations (r < 0.75) for stroke volume (114 matched pairs) and its changes (105 matched pairs). Correlation of percentage changes in stroke volume calculated by thermodilution with those derived from MD (r = 0.85) and AL (r = 0.79) was better. Changes in MD (AL) derived stroke volume by more than 20% identified changes in thermodilution-derived stroke volume greater than 20% (n = 57) with a sensitivity of 74% (70%) and a specificity of 82% (79%). Signal instability, lack of accuracy and only a moderate trend capability currently limit the intraoperative usefulness of automated TOE techniques for continuous estimation of stroke volume from a single long-axis plane.
Greim
C A
CA
Department of Anaesthesiology, University Hospital of Würzburg, Germany.
Roewer
N
N
Laux
G
G
Schulte am Esch
J
J
D000005:Abdomen / Q000601:surgery; D000162:Acoustics; D000328:Adult; D017548:Echocardiography, Transesophageal; D006801:Humans; D008875:Middle Aged; D016343:Monitoring, Intraoperative / Q000379:methods*; D012815:Signal Processing, Computer-Assisted; D013318:Stroke Volume; D013815:Thermodilution; D016277:Ventricular Function, Left