title: Comparison of esophageal Doppler, pulse contour analysis, and real-time pulmonary artery thermodilution for the continuous measurement of cardiac output.
abstract: OBJECTIVE
  Continuous measurement of cardiac output (CCO) is of great importance in the critically ill. However, pulmonary artery thermodilution has been questioned for possible complications associated with right heart catheterization. Furthermore, measurements are delayed in the continuous mode during rapid hemodynamic changes. A new pulmonary artery catheter CCO device (Aortech, Bellshill, Scotland) enabling real-time update of cardiac output was compared with 2 different, less-invasive methods of CCO determination, esophageal Doppler and pulse contour analysis.
  
  
  METHODS
  Prospective, observational study.
  
  
  METHODS
  University hospital, single institution.
  
  
  METHODS
  Patients scheduled for elective coronary artery bypass grafting (CABG).
  
  
  METHODS
  None.
  
  
  RESULTS
  CCO measurements were analyzed using a Bland-Altman plot. Bias between CCO and pulse contour cardiac output (PCCO), and Doppler-derived cardiac output (UCCO) was (mean +/- 1 SD) -0.71 +/- 1 L/min versus -0.15 +/- 1.09 L/min, and between UCCO and PCCO -0.58 +/- 1.06 L/min. Bias was not significantly different among methods, nor were comparative values before and after cardiopulmonary bypass (p > 0.05).
  
  
  CONCLUSIONS
  Agreement between the CCO method and both less-invasive measurements was clinically acceptable. There were no adverse events associated with the use of either device.
authors.affiliation: Department of Anaesthesiology and Intensive Care Medicine, University Hospital Schleswig-Holstein Campus, Kiel, Germany. bein@anaesthesie.uni-kiel.de
authors.forename: Berthold
authors.initials: B
authors.lastname: Bein
authors.forename: Frank
authors.initials: F
authors.lastname: Worthmann
authors.forename: Peter H
authors.initials: PH
authors.lastname: Tonner
authors.forename: Andrea
authors.initials: A
authors.lastname: Paris
authors.forename: Markus
authors.initials: M
authors.lastname: Steinfath
authors.forename: Jürgen
authors.initials: J
authors.lastname: Hedderich
authors.forename: Jens
authors.initials: J
authors.lastname: Scholz
mesh_terms: D000368:Aged; D015982:Bias; D002302:Cardiac Output / Q000502:physiology*; D002407:Catheterization, Swan-Ganz / Q000379:methods*; D001026:Coronary Artery Bypass / Q000379:methods; D015150:Echocardiography, Doppler / Q000379:methods*; D017548:Echocardiography, Transesophageal / Q000379:methods*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D016343:Monitoring, Intraoperative / Q000379:methods*; D008991:Monitoring, Physiologic / Q000379:methods; D011446:Prospective Studies; D011651:Pulmonary Artery / Q000502:physiology*; D011674:Pulse / Q000379:methods*; D015203:Reproducibility of Results; D012680:Sensitivity and Specificity; D013815:Thermodilution / Q000379:methods