Indian Journal of Critical Care Medicine

Register      Login

SEARCH WITHIN CONTENT

FIND ARTICLE

Volume / Issue

Online First

Archive
Volume  28 (2024)
Volume  27 (2023)
Volume  26 (2022)
Volume  25 (2021)
Volume  24 (2020)
Volume  23 (2019)
Volume  22 (2018)
Volume  21 (2017)
Volume  20 (2016)
Volume  19 (2015)
Volume  18 (2014)
Volume  17 (2013)
Volume  16 (2012)
Volume  15 (2011)
Volume  14 (2010)
Volume  13 (2009)
Volume  12 (2008)
Volume  11 (2007)
Volume  10 (2006)
Volume  9 (2005)
Volume  8 (2004)
Related articles

VOLUME 11 , ISSUE 2 ( April, 2007 ) > List of Articles

RESEARCH ARTICLE

Use of the esophageal echo-Doppler to guide intensive care unit resuscitations: A retrospective study

Peter S. Stawicki, William S. Hoff*, James Cipolla*, Nathaniel McQuay Jr, Michael D. Grossman*

Keywords : Clinical algorithm, esophageal Doppler monitor, indications and contraindications

Citation Information : Stawicki PS, Hoff* WS, Cipolla* J, McQuay Jr N, Grossman* MD. Use of the esophageal echo-Doppler to guide intensive care unit resuscitations: A retrospective study. Indian J Crit Care Med 2007; 11 (2):54-60.

DOI: 10.4103/0972-5229.33386

License: CC BY-ND 3.0

Published Online: 01-01-2011

Copyright Statement:  Copyright © 2007; The Author(s).


Abstract

Purpose: The esophageal Doppler monitoring (EDM) has emerged as an alternative to the pulmonary artery catheter (PAC). The purpose of this study is to better define its role in the ICU. Materials and Methods: Retrospective review of Hemosonic[TM] 100 EDM probe use between 2003 and 2005. Patient- and EDM-related characteristics, indications, complications, resuscitation end points (lactate, base excess - BE, left ventricular ejection time - LVET) were recorded. Comparisons between EDM and PAC were made. Results: Thirty-nine patients were monitored using the EDM. EDM-guided interventions resulted in significantly improved lactate, BE and LVET (all, P < 0.01). The change in BE correlated with change in LVET (R=0.7143, P < 0.0002). Cardiac output (CO) measurements by EDM and PAC were compared using the Bland-Altman method (mean = 0.0167, standard deviation = 0.9351, variance = 0.8745, 95% CI -1.854 to 1.887), which demonstrated that the EDM tended to underestimate CO in the lower ranges of measurements and overestimate CO in the upper ranges. Conclusions: EDM may be most helpful in ventilated/sedated patients requiring short-term hemodynamic monitoring. When compared to PAC, the EDM tends to underestimate CO in the lower range and overestimate CO in the upper range of measurements. We recommend EDM use concurrently with end-points of resuscitation.

PDF Share
  1. Pulmonary artery catheterization and the esophageal Doppler monitoring in the ICU. Chest 1999;116:1085-91.
  2. The effectiveness of right heart catheterization in the initial care of critically ill patients. JAMA 1996;276:889-97.
  3. Multicenter study of noninvasive monitoring system as alternatives to invasive monitoring of acutely ill emergency patients. Chest 1998;114:1643-52.
  4. Use of non-invasive esophageal echo-Doppler system in the ICU: A practical experience. J Trauma 2005;59:506-7.
  5. The validity of trans-esophageal Doppler ultrasonography as a measure of cardiac output in critically ill adults. Intensive Care Med 2004;30:2060-6.
  6. The esophageal Doppler monitor in mechanically ventilated surgical patients: Does it work? J Trauma 2003;55:720-6.
  7. Comparison of cardiac outputs of major burn patients undergoing extensive early escharectomy: Esophageal Doppler monitor versus thermodilution pulmonary artery catheter. J Trauma 2004;57:1013-7.
  8. A comparison of hemodynamic data derived by a pulmonary artery catheter and the esophageal Doppler monitor in preeclampsia. Am J Obstet Gynecol 2000;183:658-61.
  9. Novel indications for the use of a non-invasive esophageal echo-Doppler system in the ICU. Crit Care Med Suppl 2002;30:A63.
  10. Clinical evaluation of esophageal Doppler cardiac output measurement during general anesthesia. J Anesth 1989;3:178-82.
  11. Continuous noninvasive measurement of aortic blood flow in critically ill patients with a new esophageal echo-Doppler system. J Crit Care 1998;13:177-83.
  12. Esophageal Doppler monitoring of aortic blood flow: Beat by beat cardiac output monitoring. Int Anesthesiol Clin 1993;31:99-125.
  13. Improving risk adjustment in critically ill trauma patients: The TRISS-SAPS Score. J Trauma 2004;57:375-80.
  14. Utility of esophageal Doppler as a minimally invasive hemodynamic monitor: A review. Can J Anesth 2002;49:393-401.
  15. Noninvasive monitoring of cardiac output in critically ill patients using transesophageal Doppler. Am J Respir Crit Care Med 1998;158:77-83.
  16. Use of the esophageal Doppler and sublingual capnometer in the hemodynamic assessment of mechanically ventilated surgical patients. Chest Suppl 2004;126:874S.
  17. Move over, Mr Swan-Ganz: Finding a place for the esophageal doppler monitoring system in the ICU. Crit Care Med Suppl 2005;33:A59.
  18. Minimally invasive optimization of organ donor resuscitation: Case reports. Prog Transplant 2005;15:27-32.
  19. The esophageal Doppler monitor is useful for fluid management during the perioperative and intensive care periods. J Trauma 2005;59:508.
  20. Hemodynamic monitoring of organ donors: A novel use of the esophageal echo-Doppler probe. Am Surg 2006;72:500-4.
PDF Share
PDF Share

© Jaypee Brothers Medical Publishers (P) LTD.