| Su NY, Huang CJ, Tsai P, Hsu YW, & Cheng CR |
------>authors3_c=None ------>paper_class1=1 ------>Impact_Factor=None ------>paper_class3=1 ------>paper_class2=1 ------>vol=40 ------>confirm_bywho=chuan ------>insert_bywho=ptsai ------>Jurnal_Rank=None ------>authors4_c=None ------>comm_author= ------>patent_EDate=None ------>authors5_c=None ------>publish_day=None ------>paper_class2Letter=None ------>page2=133 ------>medlineContent= ------>unit=H0200 ------>insert_date=20030324 ------>iam=3 ------>update_date= ------>author=??? ------>change_event=6 ------>ISSN=None ------>authors_c=None ------>score=500 ------>journal_name=Acta Anaesthesiology Sinica ------>paper_name=Cardiac output measurement during cardiac surgery: esophageal Doppler versus pulmonary artery catheter ------>confirm_date=20051205 ------>tch_id=091090 ------>pmid=12434609 ------>page1=127 ------>fullAbstract=BACKGROUND: Bolus thermodilution cardiac output (BCO) measurement has been considered as the "gold standard" for cardiac output (CO) measurement. However, it requires placement of a pulmonary artery (PA) catheter, and questions have been raised regarding the risk/benefit ratio of this invasive technique. Furthermore, great variations between measurements have been reported. Continuous thermodilution CO (CCO) measurement is reported to be a better alternative, but it still requires the placement of a PA catheter. Esophageal echo-Doppler ultrasonography (ED) provides non-invasive continuous measurement of CO (ED-CO). This study was thus designed to compare the agreement between ED-CO and both thermodilution techniques (BCO and CCO). METHODS: Twenty-four patients undergoing primary coronary artery bypass graft surgery were randomized to have a PA catheter placed for measurement of either BCO or CCO. All patients also had an ED probe placed. In Group I patients (n = 12), BCO measurement was carried out every 15 minutes throughout the surgery except during cardiopulmonary bypass, with concurrent ED-CO reading recorded at the same time point. In Group II patients (n = 12), CCO and ED-CO measurements were recorded at the same designated points of time as in Group I. The agreement between methods (BCO vs. ED-CO or CCO vs. ED-CO) was assessed using Bland-Altman method. RESULTS: The range of measured CO of each method was 2.1 to 9.4 l/min for BCO, 2.4 to 9.2 l/min for CCO and 2.3 to 8.9 l/min for ED-CO. ED-CO and CCO had excellent agreement with a linear regression coefficient (r2 value) of 0.846, and a bias (mean difference) and SD of bias of 0.05 +/- 0.49 l/min. In contrast, the agreement between BCO and ED-CO was poorer; correlation was low (r2 value 0.406) and both the bias and SD of bias were high (0.11 +/- 1.12 l/min). Furthermore, BCO measurements had poor reproducibility, whereas both ED-CO and CCO measurements had good reproducibility. CONCLUSIONS: Esophageal echo-Doppler ultrasonography is a satisfactory alternative for cardiac output measurement because it gives a value in good agreement with CCO measurement. With significant between-measurement variations, the accuracy and precision of BCO are uncertain, and it should not be considered as the "gold standard". ------>tmu_sno=None ------>sno=6561 ------>authors2= ------>authors3= ------>authors4= ------>authors5= ------>authors6= ------>authors6_c=None ------>authors=Su NY, Huang CJ, Tsai P, Hsu YW, & Cheng CR ------>delete_flag=0 ------>SCI_JNo=None ------>authors2_c=None ------>publish_area=None ------>updateTitle=Cardiac output measurement during cardiac surgery: esophageal Doppler versus pulmonary artery catheter. ------>language=2 ------>check_flag= ------>submit_date= ------>country=None ------>no=3 ------>patent_SDate=None ------>update_bywho= ------>publish_year=2002 ------>submit_flag= ------>publish_month=None |