title: CO assessment by suprasternal Doppler in critically ill patients: comparison with thermodilution.
abstract: 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.
authors.affiliation: Fédération d'Anesthésie Douleur Urgences Réanimation, Centre Hospitalier Universitaire de Nîmes, France.
authors.forename: J Y
authors.initials: JY
authors.lastname: Lefrant
authors.forename: M
authors.initials: M
authors.lastname: Benbabaali
authors.forename: J
authors.initials: J
authors.lastname: Ripart
authors.forename: A G
authors.initials: AG
authors.lastname: Aya
authors.forename: G
authors.initials: G
authors.lastname: Sassi
authors.forename: M
authors.initials: M
authors.lastname: Dauzat
authors.forename: J E
authors.initials: JE
authors.lastname: de La Coussaye
authors.forename: J J
authors.initials: JJ
authors.lastname: Eledjam
mesh_terms: 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