CO assessment by suprasternal Doppler in critically ill patients: comparison with thermodilution.
OBJECTIVE
Comparison of suprasternal Doppler (SST) and thermodilution (TD) for the measurement of cardiac output (CO) in critically ill patients.


METHODS
Prospective study.


METHODS
Intensive care unit of a university hospital.


METHODS
65 consecutive critically ill patients requiring a pulmonary artery catheter.


METHODS
Paired CO measurements were made simultaneously using SST and TD by two independent operators. The time to obtain a CO value by SST was measured. Correlation coefficients and the linear regression equation were determined. A Bland and Altman diagram was plotted. A Bland and Altman diagram was also plotted for the level of cardiac index (CI) values (low: CI < 2.5 l min(-1) m(-2); normal: 2.5 < or = CI < or = 4.5 l min(-1) m(-2); high: CI > 4.5 l min(-1) m(-2)).


RESULTS
In seven patients SST failed to measure CO. In the remaining 58 patients 314 paired CO measurements were performed. The mean time to measure CO by SST was 73 +/- 45 s. The equation of linear regression was: SST(CO) = 0.84 TD(CO) + 1.39. The correlation coefficient was 0.84. The bias between SST and TD was -0.2 +/- 1.4 l min(-1). Biases were -0.23 +/- 0.50, -0.20 +/- 0.68, and 0.25 +/- 0.92 l min(-1) m(-2) for low, normal, and high levels of CI, respectively.


CONCLUSIONS
SST does not accurately measure CO but allows a rapid assessment of CI level in critically ill patients.
Lefrant
J Y
JY
Fédération d'Anesthésie Douleur Urgences Réanimation, Centre Hospitalier Universitaire de Nîmes, France.
Benbabaali
M
M
Ripart
J
J
Aya
A G
AG
Sassi
G
G
Dauzat
M
M
de La Coussaye
J E
JE
Eledjam
J J
JJ
D000328:Adult; D002302:Cardiac Output; D015150:Echocardiography, Doppler / Q000379:methods*; D005260:Female; D006439:Hemodynamics; D006801:Humans; D007362:Intensive Care Units; D016014:Linear Models; D008297:Male; D008875:Middle Aged; D010195:Pancreatitis / Q000175:diagnosis; D011182:Postoperative Care; D011446:Prospective Studies; D012772:Shock, Septic / Q000175:diagnosis; D013815:Thermodilution