title: Hemodynamic measurements after cardiac surgery: transesophageal Doppler versus pulmonary artery catheter.
abstract: OBJECTIVE
  The purpose of this study was to compare hemodynamic data derived from the transesophageal Doppler monitor (Medicina TECO, Berkshire, United Kingdom) against those obtained from a pulmonary artery catheter after coronary artery bypass grafting (CABG).
  
  
  METHODS
  Prospective, nonrandomized, clinical study.
  
  
  METHODS
  Single, tertiary referral center.
  
  
  METHODS
  Thirty-five adult patients.
  
  
  METHODS
  Cardiac output and hemodynamic variables were measured and compared at 4 predefined time points in patients undergoing elective off-pump CABG surgery from January 2003 through June 2003.
  
  
  RESULTS
  A total of 140 pairs for cardiac output (CO) data were obtained. Transesophageal cardiac output (TECO) values ranged from 1.9 to 8.7 L/min. Thermodilution cardiac output (TDCO) values ranged from 2.7 to 7.6 L/min. Matched measurements were made with each patient at intervals of 30 minutes. Bland-Altman analysis revealed a mean bias of 1.18 +/- 1.36 L/min, with a correlation (r) of 0.593 (p < 0.000) between TECO and TDCO. Similarly poor correlation was observed among cardiac index (r = 0.523), stroke volume (r = 0.615), systemic vascular resistance (r = 0.595), left ventricular stroke work index (r = 0.594), and right ventricular stroke work index (r = 0.590) measured by an esophageal Doppler monitor against a pulmonary artery catheter.
  
  
  CONCLUSIONS
  A transesophageal Doppler device (Medicina TECO) cannot be relied on as a sole method for monitoring cardiac output and derived hemodynamic variables in patients after CABG surgery.
authors.affiliation: Department of Anesthesiology and Critical Care, Escorts Heart Institute and Research Centre, New Delhi, India.
authors.forename: Jeetendra
authors.initials: J
authors.lastname: Sharma
authors.forename: Milind
authors.initials: M
authors.lastname: Bhise
authors.forename: Ajmer
authors.initials: A
authors.lastname: Singh
authors.forename: Yatin
authors.initials: Y
authors.lastname: Mehta
authors.forename: Naresh
authors.initials: N
authors.lastname: Trehan
mesh_terms: D000368:Aged; D002302:Cardiac Output / Q000502:physiology; D006348:Cardiac Surgical Procedures; D002407:Catheterization, Swan-Ganz; D001026:Coronary Artery Bypass; D017548:Echocardiography, Transesophageal; D005260:Female; D006439:Hemodynamics; D006801:Humans; D008297:Male; D008875:Middle Aged; D008991:Monitoring, Physiologic; D011184:Postoperative Period; D011446:Prospective Studies; D013815:Thermodilution