CO assessment by suprasternal Doppler in critically ill patients: comparison with thermodilution.
作者信息
Lefrant J Y, Benbabaali M, Ripart J, Aya A G, Sassi G, Dauzat M, de La Coussaye J E, Eledjam J J
机构信息
Fédération d'Anesthésie Douleur Urgences Réanimation, Centre Hospitalier Universitaire de Nîmes, France.
出版信息
Intensive Care Med. 2000 Jun;26(6):693-7. doi: 10.1007/s001340051234.
OBJECTIVE
Comparison of suprasternal Doppler (SST) and thermodilution (TD) for the measurement of cardiac output (CO) in critically ill patients.
DESIGN
Prospective study.
SETTING
Intensive care unit of a university hospital.
PATIENTS AND PARTICIPANTS
65 consecutive critically ill patients requiring a pulmonary artery catheter.
INTERVENTIONS
Paired CO measurements were made simultaneously using SST and TD by two independent operators. The time to obtain a CO value by SST was measured. Correlation coefficients and the linear regression equation were determined. A Bland and Altman diagram was plotted. A Bland and Altman diagram was also plotted for the level of cardiac index (CI) values (low: CI < 2.5 l min(-1) m(-2); normal: 2.5 < or = CI < or = 4.5 l min(-1) m(-2); high: CI > 4.5 l min(-1) m(-2)).
MEASUREMENTS AND RESULTS
In seven patients SST failed to measure CO. In the remaining 58 patients 314 paired CO measurements were performed. The mean time to measure CO by SST was 73 +/- 45 s. The equation of linear regression was: SST(CO) = 0.84 TD(CO) + 1.39. The correlation coefficient was 0.84. The bias between SST and TD was -0.2 +/- 1.4 l min(-1). Biases were -0.23 +/- 0.50, -0.20 +/- 0.68, and 0.25 +/- 0.92 l min(-1) m(-2) for low, normal, and high levels of CI, respectively.
CONCLUSION
SST does not accurately measure CO but allows a rapid assessment of CI level in critically ill patients.
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