Hemodynamic measurements after cardiac surgery: transesophageal Doppler versus pulmonary artery catheter.
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.
Sharma
Jeetendra
J
Department of Anesthesiology and Critical Care, Escorts Heart Institute and Research Centre, New Delhi, India.
Bhise
Milind
M
Singh
Ajmer
A
Mehta
Yatin
Y
Trehan
Naresh
N
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