title: Residents and ICU nurses get reliable static and dynamic haemodynamic assessments with aortic oesophageal Doppler.
abstract: BACKGROUND
  Aortic oesophageal Doppler (ODM) allows continuous non-invasive haemodynamic monitoring. We tested to confirm if residents and nurses were able to reposition oesophageal probe (OP), obtain aortic blood flow of good quality and so perform reliable static and dynamic haemodynamic assessments.
  
  
  METHODS
  Prospective observational study assessing ODM measurements were obtained by six residents and three nurses after they have participated in training. Measured (aortic diameter) and calculated haemodynamic data [indexed stroke volume (SVI), cardiac index] were directly obtained from ODM, after residents and nurses repositioned the OP. In a second group of patients, we tested the ability of residents and nurses to detect rapid haemodynamic changes after a passive leg raising. SVI comparison was the primary end point. Statistical analysis was performed using the method of Bland and Altman.
  
  
  RESULTS
  Sixty-six haemodynamic measurements were performed on 42 patients. Mean bias for SVI between the skilled physician and residents, and between the skilled physician and nurses were -0.9 ± 5.2 ml/m(2) (P = 0.15), with a percentage error of 31%, and 0.9 ± 5.1 ml/m(2) (P = 0.14), with a percentage error of 33%, respectively. There was an excellent correlation for SVI between the physician and residents (r = 0.9; P < 0.0001) and between the physician and nurses (r = 0.9; P < 0.0001). Induced changes in SVI measured by residents and nurses strongly followed those of our skilled physician.
  
  
  CONCLUSIONS
  Residents and nurses get reliable static and dynamic haemodynamic assessments with ODM compared to our skilled physician.
authors.affiliation: Département d'Anesthésie-Réanimation, Hôpital Edouard Herriot, Hospices Civils de Lyon, Lyon Cedex, France.
authors.forename: J M
authors.initials: JM
authors.lastname: Robert
authors.forename: B
authors.initials: B
authors.lastname: Floccard
authors.forename: J
authors.initials: J
authors.lastname: Crozon
authors.forename: E M
authors.initials: EM
authors.lastname: Boyle
authors.forename: A
authors.initials: A
authors.lastname: Levrat
authors.forename: C
authors.initials: C
authors.lastname: Guillaume
authors.forename: F
authors.initials: F
authors.lastname: Benatir
authors.forename: A
authors.initials: A
authors.lastname: Faure
authors.forename: G
authors.initials: G
authors.lastname: Marcotte
authors.forename: E
authors.initials: E
authors.lastname: Hautin
authors.forename: B
authors.initials: B
authors.lastname: Allaouchiche
mesh_terms: D000368:Aged; D001011:Aorta / Q000000981:diagnostic imaging / Q000502:physiology*; D002302:Cardiac Output; D004947:Esophagus / Q000000981:diagnostic imaging*; D005260:Female; D006439:Hemodynamics; D006801:Humans; D007362:Intensive Care Units; D007396:Internship and Residency; D008297:Male; D008875:Middle Aged; D008991:Monitoring, Physiologic / Q000295:instrumentation; D009726:Nurses; D018608:Ultrasonography, Doppler / Q000379:methods*