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Measurements of cardiac output obtained with transesophageal echocardiography and pulmonary artery thermodilution are not interchangeable

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@article{bcbdd0d9808e42b6bf2efa33b7ee57b0,
title = "Measurements of cardiac output obtained with transesophageal echocardiography and pulmonary artery thermodilution are not interchangeable",
abstract = "BACKGROUND: Echocardiography is increasingly becoming an integrated tool for circulatory evaluation in the intensive care unit and the operating room. Therefore, it is imperative to know the reproducibility of measurements obtained by echocardiography. In this study, a comparison of cardiac output (CO) measurements obtained with transesophageal echocardiography (TEE) and pulmonary artery catheter (PAC) thermodilution (TD) was carried out to test the precision, accuracy and trending ability of CO measurements obtained with TEE.METHODS: Twenty-five patients completed the study. Each patient was placed in the following successive positions: supine, head-down tilt, head-up tilt, supine, supine with phenylephrine administration, pace heart rate 80 beats per minute (bpm), pace heart rate 110 bpm. TEE CO and PAC CO were measured simultaneously. The agreement was analysed by Bland-Altman plots, and to assess trending ability, a polar plot was constructed.RESULTS: Both methods showed an acceptable precision 8% (PAC TD) and 16% (TEE). In comparison with PAC TD, the TEE was associated with a bias of -0.22 l/minute [95% confidence interval: -0.54; 0.10], wide limits of agreement (-1.73 l/minute; 1.29 l/minute), a percentage error of 38.6% and a trending ability with a radial degree of 53.6°, corresponding to a poor trending ability.CONCLUSION: In comparison, CO measurements obtained with TEE and PAC TD had wide limits of agreement, a larger percentage error than would be expected from the precision of the two methods, and a poor trending ability. Thus, TEE is not interchangeable with PAC TD for measuring CO.",
keywords = "Aged, Aged, 80 and over, Algorithms, Anesthesia, General, Cardiac Output, Coronary Artery Bypass, Echocardiography, Transesophageal, Female, Hemodynamics, Humans, Male, Middle Aged, Monitoring, Intraoperative, Multiple Organ Failure, Phenylephrine, Posture, Pulmonary Artery, Reproducibility of Results, Respiratory Distress Syndrome, Adult, Thermodilution, Vasoconstrictor Agents",
author = "H M{\o}ller-S{\o}rensen and K Graeser and Hansen, {K L} and Mikhail Zemtsovski and Sander, {Esther Malte} and Nilsson, {J C}",
note = "{\textcopyright} 2013 The Acta Anaesthesiologica Scandinavica Foundation. Published by John Wiley & Sons Ltd.",
year = "2014",
month = jan,
doi = "10.1111/aas.12227",
language = "English",
volume = "58",
pages = "80--8",
journal = "Acta Anaesthesiologica Scandinavica",
issn = "0001-5172",
publisher = "Wiley-Blackwell Munksgaard",
number = "1",

}

RIS

TY - JOUR

T1 - Measurements of cardiac output obtained with transesophageal echocardiography and pulmonary artery thermodilution are not interchangeable

AU - Møller-Sørensen, H

AU - Graeser, K

AU - Hansen, K L

AU - Zemtsovski, Mikhail

AU - Sander, Esther Malte

AU - Nilsson, J C

N1 - © 2013 The Acta Anaesthesiologica Scandinavica Foundation. Published by John Wiley & Sons Ltd.

PY - 2014/1

Y1 - 2014/1

N2 - BACKGROUND: Echocardiography is increasingly becoming an integrated tool for circulatory evaluation in the intensive care unit and the operating room. Therefore, it is imperative to know the reproducibility of measurements obtained by echocardiography. In this study, a comparison of cardiac output (CO) measurements obtained with transesophageal echocardiography (TEE) and pulmonary artery catheter (PAC) thermodilution (TD) was carried out to test the precision, accuracy and trending ability of CO measurements obtained with TEE.METHODS: Twenty-five patients completed the study. Each patient was placed in the following successive positions: supine, head-down tilt, head-up tilt, supine, supine with phenylephrine administration, pace heart rate 80 beats per minute (bpm), pace heart rate 110 bpm. TEE CO and PAC CO were measured simultaneously. The agreement was analysed by Bland-Altman plots, and to assess trending ability, a polar plot was constructed.RESULTS: Both methods showed an acceptable precision 8% (PAC TD) and 16% (TEE). In comparison with PAC TD, the TEE was associated with a bias of -0.22 l/minute [95% confidence interval: -0.54; 0.10], wide limits of agreement (-1.73 l/minute; 1.29 l/minute), a percentage error of 38.6% and a trending ability with a radial degree of 53.6°, corresponding to a poor trending ability.CONCLUSION: In comparison, CO measurements obtained with TEE and PAC TD had wide limits of agreement, a larger percentage error than would be expected from the precision of the two methods, and a poor trending ability. Thus, TEE is not interchangeable with PAC TD for measuring CO.

AB - BACKGROUND: Echocardiography is increasingly becoming an integrated tool for circulatory evaluation in the intensive care unit and the operating room. Therefore, it is imperative to know the reproducibility of measurements obtained by echocardiography. In this study, a comparison of cardiac output (CO) measurements obtained with transesophageal echocardiography (TEE) and pulmonary artery catheter (PAC) thermodilution (TD) was carried out to test the precision, accuracy and trending ability of CO measurements obtained with TEE.METHODS: Twenty-five patients completed the study. Each patient was placed in the following successive positions: supine, head-down tilt, head-up tilt, supine, supine with phenylephrine administration, pace heart rate 80 beats per minute (bpm), pace heart rate 110 bpm. TEE CO and PAC CO were measured simultaneously. The agreement was analysed by Bland-Altman plots, and to assess trending ability, a polar plot was constructed.RESULTS: Both methods showed an acceptable precision 8% (PAC TD) and 16% (TEE). In comparison with PAC TD, the TEE was associated with a bias of -0.22 l/minute [95% confidence interval: -0.54; 0.10], wide limits of agreement (-1.73 l/minute; 1.29 l/minute), a percentage error of 38.6% and a trending ability with a radial degree of 53.6°, corresponding to a poor trending ability.CONCLUSION: In comparison, CO measurements obtained with TEE and PAC TD had wide limits of agreement, a larger percentage error than would be expected from the precision of the two methods, and a poor trending ability. Thus, TEE is not interchangeable with PAC TD for measuring CO.

KW - Aged

KW - Aged, 80 and over

KW - Algorithms

KW - Anesthesia, General

KW - Cardiac Output

KW - Coronary Artery Bypass

KW - Echocardiography, Transesophageal

KW - Female

KW - Hemodynamics

KW - Humans

KW - Male

KW - Middle Aged

KW - Monitoring, Intraoperative

KW - Multiple Organ Failure

KW - Phenylephrine

KW - Posture

KW - Pulmonary Artery

KW - Reproducibility of Results

KW - Respiratory Distress Syndrome, Adult

KW - Thermodilution

KW - Vasoconstrictor Agents

U2 - 10.1111/aas.12227

DO - 10.1111/aas.12227

M3 - Journal article

C2 - 24192143

VL - 58

SP - 80

EP - 88

JO - Acta Anaesthesiologica Scandinavica

JF - Acta Anaesthesiologica Scandinavica

SN - 0001-5172

IS - 1

ER -

ID: 44893072