[Comparison between two methods for hemodynamic measurement: thermodilution and oesophageal doppler].
OBJECTIVE
Thermodilution (TD) is the "gold standard method" for hemodynamic monitoring. Some parameters can be measured by Oesophageal Doppler (OD), which is simpler and less invasive. To evaluate the accuracy of OD, we compared this method with TD in measurement of cardiac output (CO).


METHODS
One hundred and ninety two simultaneous measurements were made in 10 patients (5 male and 5 female) with different clinical situations, 8 with sepsis using vasoactive drugs and 2 monitored for laryngectomy and liver transplantation. Measurements were taken during 4 hours at 30 minute intervals. The two oesophageal dopplers used DeltexR and ArrowR, were introduced between 35 and 45 cm from the nose and located at the point of largest diameter of the descending aorta. In TD, we used the pulmonary artery catheter (Swan Ganz BaxterR) and the DX- 2001 monitorR positioning was confirmed with support of radiology and of pressures curves. Measurements of CO carried out by means of TD were achieved using an iced saline solution considering the mean of four measurements with less than a 5% difference. The statistical method used was the Bland-Altman scatter plot and dispersion graphic.


RESULTS
No statistically significant difference was found between the two methods for hemodyamic measurement with a correlation coefficient of 0.8 for CO (Deltex DopplerR and Baxter Swan GanzR) and a correlation coefficient of 0.99 for CO (Arrow DopplerR and Baxter Swan GanzR).


CONCLUSIONS
Homodynamic measurements with OD have the same accuracy as those with TD and were easily obtained in the 10 patients.
Ferreira
Roberto Manara Victorio
RM
Centro de Ensino e Treinamento, Unifesp. rmanara@yahoo.com
do Amaral
José Luiz Gomes
JL
Valiatti
Jorge Luís dos Santos
JL
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002302:Cardiac Output / Q000502:physiology*; D015150:Echocardiography, Doppler / Q000295:instrumentation / Q000379:methods*; D017548:Echocardiography, Transesophageal / Q000295:instrumentation / Q000379:methods*; D004812:Epidemiologic Methods; D005260:Female; D006439:Hemodynamics / Q000502:physiology*; D006801:Humans; D007825:Laryngectomy; D016031:Liver Transplantation; D008297:Male; D008875:Middle Aged; D013815:Thermodilution / Q000379:methods*; D014662:Vasoconstrictor Agents / Q000627:therapeutic use