Document Detail


The esophageal Doppler monitor in mechanically ventilated surgical patients: does it work?
MedLine Citation:
PMID:  14566129     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND: Assessment of cardiac volumes and cardiac output (CO) using a pulmonary artery catheter (PAC) in mechanically ventilated patients can be inconsistent and difficult. The esophageal Doppler monitor (EDM) is emerging as a potential alternative to the PAC. This prospective study evaluated the comparative accuracy between the PAC and EDM for preload assessment and CO in mechanically ventilated surgical patients. METHODS The EDM was placed in 15 patients with PACs in place. A total of 187 simultaneously measured EDM and PAC comparative data sets were obtained. The Pearson correlation (r) was used to compare measurements, with significance defined as a value of p < 0.05. RESULTS: CO measured by EDM and PAC correlated closely (r = 0.97, p < 0.0001). Corrected flow time (FTc), a measure of left ventricular filling, correlated with PAC CO to the same degree as pulmonary capillary wedge pressure (PCWP) when positive end-expiratory pressure (PEEP) was < 10 cm H2O (FTc, r = 0.51; PCWP, r = 0.56). When PEEP was > or = 10 cm H2O, FTc correlated with PAC CO better than PCWP (FTc, r = 0.85; PCWP, r = 0.29). CONCLUSION: FTc correlates with EDM and PAC CO better than PCWP. On the basis of the current study, it is reasonable to conclude that the EDM is a valuable adjunct technology for CO and preload assessment in surgical patients on mechanical ventilation, regardless of the level of mechanical ventilatory support.
Authors:
Hani M Seoudi; Melissa F Perkal; Ann Hanrahan; Peter B Angood
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Publication Detail:
Type:  Comparative Study; Journal Article; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  The Journal of trauma     Volume:  55     ISSN:  0022-5282     ISO Abbreviation:  J Trauma     Publication Date:  2003 Oct 
Date Detail:
Created Date:  2003-10-20     Completed Date:  2003-11-24     Revised Date:  2009-11-03    
Medline Journal Info:
Nlm Unique ID:  0376373     Medline TA:  J Trauma     Country:  United States    
Other Details:
Languages:  eng     Pagination:  720-5; discussion 725-6     Citation Subset:  AIM; IM    
Affiliation:
Department of Surgery, Section of Trauma and Surgical Critical Care, Yale University School of Medicine, New Haven, Connecticut, USA.
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MeSH Terms
Descriptor/Qualifier:
Aged
Aged, 80 and over
Cardiac Output / physiology
Esophagus / ultrasonography*
Female
Heart Catheterization
Humans
Male
Middle Aged
Monitoring, Physiologic / methods*
Prospective Studies
Pulmonary Artery
Respiration, Artificial*
Ultrasonography, Doppler*

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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