Thoracic electrical bioimpedance versus suprasternal Doppler in emergency care.
OBJECTIVE
There are a number of cardiac output (CO) monitors that could potentially be used in the ED. Two of the most promising methods, thoracic electrical bioimpedance and suprasternal Doppler, have not been directly compared. The aim of this study was to investigate the feasibility of CO monitoring using suprasternal Doppler and bioimpedance in emergency care and compare haemodynamic data obtained from both monitors.


METHODS
Haemodynamic measurements were made on the same group of patients using bioimpedance (Niccomo, Medis, Germany) and suprasternal Doppler (USCOM, Sydney, Australia).


RESULTS
Usable CO data were obtained in 97% of patients by suprasternal Doppler and 87% by bioimpedance. The median CO obtained by Doppler was 3.4 L/min lower than bioimpedance. The stroke volume median was lower by 51 mL in Doppler.


CONCLUSIONS
These two methods of non-invasive cardiac monitoring are not interchangeable. The results suggest that the choice of non-invasive cardiac monitor is important, but the grounds on which to make this choice are not currently clear.
Department of Emergency Medicine, Alexandria University, Alexandria, Egypt.|Emergency Medicine Academic Group, Department of Cardiovascular Sciences, University of Leicester, Leicester, UK.
Mohammed H
http://orcid.org/0000-0002-6825-9663
MH
Elwan
Department of Physics, University of Leicester, Leicester, UK.
Jeremy
J
Hue
Emergency Department, Homerton University Hospital, London, UK.
Samira J
SJ
Green
Department of Emergency Medicine, Alexandria University, Alexandria, Egypt.
Salah M
SM
Eltahan
Department of Physics, University of Leicester, Leicester, UK.
Mark R
MR
Sims
Emergency Medicine Academic Group, Department of Cardiovascular Sciences, University of Leicester, Leicester, UK.
Timothy J
TJ
Coats
D000328:Adult; D000368:Aged; D002302:Cardiac Output; D015150:Echocardiography, Doppler / Q000592:standards*; D017097:Electric Impedance / Q000627:therapeutic use*; D004632:Emergency Medical Services / Q000379:methods* / Q000639:trends; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D008991:Monitoring, Physiologic / Q000379:methods / Q000592:standards*; D013318:Stroke Volume; D006113:United Kingdom
Doppler; bioimpedance; cardiac output; haemodynamics; non-invasive monitoring; resuscitation