Non-invasive cardiac output determination by two-dimensional independent Doppler during and after cardiac surgery.
OBJECTIVE
This study was to compare noninvasive measurement of cardiac output (CO) using a novel Doppler technique with invasive CO measurements in the postcardiac surgical intensive care unit.


METHODS
Thirty-six patients (67.2 +/- 10 years, New York Heart Association functional class 3.1 +/- 0.3) undergoing coronary revascularization were prospectively examined postoperatively. One hundred eighty paired CO and stroke volume measurements were compared from the noninvasive USCOM device (Sydney, Australia) and the invasive Swan-Ganz catheter at varying COs. Eighteen measurements were performed intraoperatively by direct insonation of the right ventricular outflow tract.


RESULTS
Mean noninvasive and invasive CO values were 5.15 +/- 1.98 L/min and 4.92 +/- 2.0 L/min, respectively (r = 0.870; p < 0.01). The mean difference between methods was -0.23 +/- 1.01 L/min greater than a range of CO values from 2.5 to 9.9 L/min. Mean central venous saturation percentage was 72 +/- 9%, correlating with both noninvasive and invasive CO (r = 0.474 and 0.606, respectively, p < 0.01). Intraoperatively, both direct and invasive CO were identical.


CONCLUSIONS
Using the ultrasonic cardiac output monitoring (USCOM) device it is possible to determine noninvasive beat-to-beat CO in postcardiac surgery patients without the possible complications associated with invasive right heart catheterization. The USCOM CO and stroke volume showed a very good agreement with invasive Swan-Ganz measures and correlated with central venous saturation percentage.
Knobloch
Karsten
K
Department of Trauma Surgery, Medical School Hannover, Hannover, Germany. kknobi@yahoo.com
Lichtenberg
Artur
A
Winterhalter
Michael
M
Rossner
Dagmar
D
Pichlmaier
Max
M
Phillips
Rob
R
D000368:Aged; D002302:Cardiac Output; D006348:Cardiac Surgical Procedures; D003422:Critical Care / Q000379:methods; D015150:Echocardiography, Doppler / Q000379:methods*; D005260:Female; D006439:Hemodynamics; D006801:Humans; D008297:Male; D016343:Monitoring, Intraoperative / Q000379:methods; D011182:Postoperative Care / Q000379:methods; D011446:Prospective Studies; D011651:Pulmonary Artery / Q000000981:diagnostic imaging; D015203:Reproducibility of Results