Transesophageal Doppler reliably tracks changes in cardiac output in comparison with intermittent pulmonary artery thermodilution in cardiac surgery patients

Hasse Møller-Sørensen; Joakim Cordtz; Morten Østergaard; Jens C Nilsson; Kristoffer L Hansen

doi:10.1007/s10877-015-9806-4

Transesophageal Doppler reliably tracks changes in cardiac output in comparison with intermittent pulmonary artery thermodilution in cardiac surgery patients

Hasse Møller-Sørensen, Joakim Cordtz, Morten Østergaard, Jens C Nilsson, Kristoffer L Hansen

Department of Clinical Medicine

8 Citations (Scopus)

Abstract

In this study a comparison of cardiac output (CO) measurements obtained with CardioQ transesophageal Doppler (TED) and pulmonary artery catheter (PAC) thermodilution (TD) technique was done in a systematic set-up, with induced changes in preload, afterload and heart rate. Twenty-five patients completed the study. Each patient were placed in the following successive positions: (1) supine, (2) head-down tilt, (3) head-up tilt, (4) supine, (5) supine with phenylephrine administration, (6) pace heart rate 80 beats per minute (bpm), (7) pace heart rate 110 bpm. The agreement of compared data was investigated by Bland-Altman plots, and to assess trending ability a four quadrants plot and a polar plot were constructed. Both methods showed an acceptable precision 6.4 % (PAC TD) and 12.8 % (TED). In comparison with PAC TD, the TED was associated with a mean bias in supine position of -0.30 l min(-1) (95 % CI -0.88; 0.27), wide limits of agreement, a percentage error of 69.5 %, and a trending ability with a concordance rate of 92 %, angular bias of 1.1° and a radial sector size of 40.0° corresponding to an acceptable trending ability. In comparison with PAC TD, the CardioQ TED showed a low mean bias, wide limits of agreement and a larger percentage error than should be expected from the precision of the two methods. However, an acceptable trending ability was found. Thus, the CardioQ TED should not replace CO measurements done by PAC TD, but could be a valuable tool in guiding therapy.

Original language	English
Journal	Journal of Clinical Monitoring and Computing
Volume	31
Issue number	1
Pages (from-to)	135-142
ISSN	1387-1307
DOIs	https://doi.org/10.1007/s10877-015-9806-4
Publication status	Published - 1 Feb 2017

Keywords

Aged
Aged, 80 and over
Algorithms
Cardiac Output
Cardiac Surgical Procedures
Catheterization, Swan-Ganz
Coronary Artery Bypass
Echocardiography, Transesophageal
Female
Hemodynamics
Humans
Male
Middle Aged
Monitoring, Intraoperative
Patient Positioning
Pulmonary Artery
Reproducibility of Results
Signal Processing, Computer-Assisted
Thermodilution
Time Factors
Journal Article

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10.1007/s10877-015-9806-4

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Transesophageal Doppler reliably tracks changes in cardiac output in comparison with intermittent pulmonary artery thermodilution in cardiac surgery patients. / Møller-Sørensen, Hasse; Cordtz, Joakim; Østergaard, Morten et al.

In: Journal of Clinical Monitoring and Computing, Vol. 31, No. 1, 01.02.2017, p. 135-142.

Research output: Contribution to journal › Journal article › Research › peer-review

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abstract = "In this study a comparison of cardiac output (CO) measurements obtained with CardioQ transesophageal Doppler (TED) and pulmonary artery catheter (PAC) thermodilution (TD) technique was done in a systematic set-up, with induced changes in preload, afterload and heart rate. Twenty-five patients completed the study. Each patient were placed in the following successive positions: (1) supine, (2) head-down tilt, (3) head-up tilt, (4) supine, (5) supine with phenylephrine administration, (6) pace heart rate 80 beats per minute (bpm), (7) pace heart rate 110 bpm. The agreement of compared data was investigated by Bland-Altman plots, and to assess trending ability a four quadrants plot and a polar plot were constructed. Both methods showed an acceptable precision 6.4 % (PAC TD) and 12.8 % (TED). In comparison with PAC TD, the TED was associated with a mean bias in supine position of -0.30 l min(-1) (95 % CI -0.88; 0.27), wide limits of agreement, a percentage error of 69.5 %, and a trending ability with a concordance rate of 92 %, angular bias of 1.1° and a radial sector size of 40.0° corresponding to an acceptable trending ability. In comparison with PAC TD, the CardioQ TED showed a low mean bias, wide limits of agreement and a larger percentage error than should be expected from the precision of the two methods. However, an acceptable trending ability was found. Thus, the CardioQ TED should not replace CO measurements done by PAC TD, but could be a valuable tool in guiding therapy.",

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T1 - Transesophageal Doppler reliably tracks changes in cardiac output in comparison with intermittent pulmonary artery thermodilution in cardiac surgery patients

AU - Møller-Sørensen, Hasse

AU - Cordtz, Joakim

AU - Østergaard, Morten

AU - Nilsson, Jens C

AU - Hansen, Kristoffer L

PY - 2017/2/1

Y1 - 2017/2/1

N2 - In this study a comparison of cardiac output (CO) measurements obtained with CardioQ transesophageal Doppler (TED) and pulmonary artery catheter (PAC) thermodilution (TD) technique was done in a systematic set-up, with induced changes in preload, afterload and heart rate. Twenty-five patients completed the study. Each patient were placed in the following successive positions: (1) supine, (2) head-down tilt, (3) head-up tilt, (4) supine, (5) supine with phenylephrine administration, (6) pace heart rate 80 beats per minute (bpm), (7) pace heart rate 110 bpm. The agreement of compared data was investigated by Bland-Altman plots, and to assess trending ability a four quadrants plot and a polar plot were constructed. Both methods showed an acceptable precision 6.4 % (PAC TD) and 12.8 % (TED). In comparison with PAC TD, the TED was associated with a mean bias in supine position of -0.30 l min(-1) (95 % CI -0.88; 0.27), wide limits of agreement, a percentage error of 69.5 %, and a trending ability with a concordance rate of 92 %, angular bias of 1.1° and a radial sector size of 40.0° corresponding to an acceptable trending ability. In comparison with PAC TD, the CardioQ TED showed a low mean bias, wide limits of agreement and a larger percentage error than should be expected from the precision of the two methods. However, an acceptable trending ability was found. Thus, the CardioQ TED should not replace CO measurements done by PAC TD, but could be a valuable tool in guiding therapy.

AB - In this study a comparison of cardiac output (CO) measurements obtained with CardioQ transesophageal Doppler (TED) and pulmonary artery catheter (PAC) thermodilution (TD) technique was done in a systematic set-up, with induced changes in preload, afterload and heart rate. Twenty-five patients completed the study. Each patient were placed in the following successive positions: (1) supine, (2) head-down tilt, (3) head-up tilt, (4) supine, (5) supine with phenylephrine administration, (6) pace heart rate 80 beats per minute (bpm), (7) pace heart rate 110 bpm. The agreement of compared data was investigated by Bland-Altman plots, and to assess trending ability a four quadrants plot and a polar plot were constructed. Both methods showed an acceptable precision 6.4 % (PAC TD) and 12.8 % (TED). In comparison with PAC TD, the TED was associated with a mean bias in supine position of -0.30 l min(-1) (95 % CI -0.88; 0.27), wide limits of agreement, a percentage error of 69.5 %, and a trending ability with a concordance rate of 92 %, angular bias of 1.1° and a radial sector size of 40.0° corresponding to an acceptable trending ability. In comparison with PAC TD, the CardioQ TED showed a low mean bias, wide limits of agreement and a larger percentage error than should be expected from the precision of the two methods. However, an acceptable trending ability was found. Thus, the CardioQ TED should not replace CO measurements done by PAC TD, but could be a valuable tool in guiding therapy.

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KW - Cardiac Surgical Procedures

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KW - Coronary Artery Bypass

KW - Echocardiography, Transesophageal

KW - Female

KW - Hemodynamics

KW - Humans

KW - Male

KW - Middle Aged

KW - Monitoring, Intraoperative

KW - Patient Positioning

KW - Pulmonary Artery

KW - Reproducibility of Results

KW - Signal Processing, Computer-Assisted

KW - Thermodilution

KW - Time Factors

KW - Journal Article

U2 - 10.1007/s10877-015-9806-4

DO - 10.1007/s10877-015-9806-4

M3 - Journal article

C2 - 26578096

SN - 1387-1307

VL - 31

SP - 135

EP - 142

JO - Journal of Clinical Monitoring and Computing

JF - Journal of Clinical Monitoring and Computing

IS - 1

ER -

Transesophageal Doppler reliably tracks changes in cardiac output in comparison with intermittent pulmonary artery thermodilution in cardiac surgery patients

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