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Ann Thorac Surg 2005;80:1479-1483
© 2005 The Society of Thoracic Surgeons

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New technology

Non-Invasive Cardiac Output Determination by Two-Dimensional Independent Doppler During and After Cardiac Surgery

^a Department of Trauma Surgery, Hannover, Germany
^b Department of Thoracic and Cardiovascular Surgery, Hannover, Germany
^c Department of Anesthesiology, Hannover, Germany
^d Department of Gynecology, Medical School Hannover, Hannover, Germany
^e University of Queensland, Brisbane, Qld, Australia

Accepted for publication December 21, 2004.

^_* Address reprint requests to Dr Knobloch, Department of Trauma Surgery, Hannover Medical School, Carl-Neuberg-Str 1, Hannover, 30625 Germany (Email: kknobi{at}yahoo.com).

PURPOSE: This study was to compare noninvasive measurement of cardiac output (CO) using a novel Doppler technique with invasive CO measurements in the postcardiac surgical intensive care unit.

DESCRIPTION: Thirty-six patients (67.2 ± 10 years, New York Heart Association functional class 3.1 ± 0.3) undergoing coronary revascularization were prospectively examined postoperatively. One hundred eighty paired CO and stroke volume measurements were compared from the noninvasive USCOM device (Sydney, Australia) and the invasive Swan-Ganz catheter at varying COs. Eighteen measurements were performed intraoperatively by direct insonation of the right ventricular outflow tract.

EVALUATION: Mean noninvasive and invasive CO values were 5.15 ± 1.98 L/min and 4.92 ± 2.0 L/min, respectively (r = 0.870; p < 0.01). The mean difference between methods was –0.23 ± 1.01 L/min greater than a range of CO values from 2.5 to 9.9 L/min. Mean central venous saturation percentage was 72 ± 9%, correlating with both noninvasive and invasive CO (r = 0.474 and 0.606, respectively, p < 0.01). Intraoperatively, both direct and invasive CO were identical.

CONCLUSIONS: Using the ultrasonic cardiac output monitoring (USCOM) device it is possible to determine noninvasive beat-to-beat CO in postcardiac surgery patients without the possible complications associated with invasive right heart catheterization. The USCOM CO and stroke volume showed a very good agreement with invasive Swan-Ganz measures and correlated with central venous saturation percentage.

This article has been cited by other articles:

				K. Knobloch eComment: Double-knotted Swan-Ganz catheter - potential for non-invasive ultrasonic cardiac output monitoring? Interactive CardioVascular and Thoracic Surgery, October 1, 2008; 7(5): 862 - 863. [Full Text] [PDF]

				L. Siu, A. Tucker, S. K. Manikappa, and J. Monagle Does Patient Position Influence Doppler Signal Quality from the USCOM Ultrasonic Cardiac Output Monitor? Anesth. Analg., June 1, 2008; 106(6): 1798 - 1802. [Abstract] [Full Text] [PDF]

				K. Knobloch, M. Spies, and P. M. Vogt The more the better? Cardiac output monitoring during cardiopulmonary rescuscitation. Interactive CardioVascular and Thoracic Surgery, February 1, 2008; 7(1): 157 - 157. [Full Text] [PDF]

				R. Savage and L. G. Svensson Invited commentary Ann. Thorac. Surg., October 1, 2005; 80(4): 1483 - 1484. [Full Text] [PDF]