Jain S, Allins A, Salim A, Vafa A, Wilson MT, Margulies DR
Noninvasive Doppler ultrasonography for assessing cardiac function: can it replace the Swan-Ganz catheter? [Clinical Trial, Phase I, Clinical Trial, Phase II, Comparative Study, Journal Article, Randomized Controlled Trial]
Am J Surg 2008 Dec; 196(6):961-7; discussion 967-8.
BACKGROUND: Cardiac function, including cardiac index (CI), traditionally has been measured by a pulmonary artery catheter (PAC). A noninvasive alternative for measuring cardiac function would offer obvious advantages.
METHODS: A prospective study of trauma and nontrauma patients was performed in a surgical intensive care unit over a 3-month period. CI was determined using both a standard PAC and a continuous-wave Doppler ultrasound (UTS). The study had 2 phases: phase I was nonblinded and phase II was blinded; the correlation between UTS- and PAC-derived CI was assessed.
RESULTS: A total of 120 paired measurements of CI were observed in 31 patients. The UTS-derived CI measurements showed agreement with PAC measurements in both phase I and phase II of the study with a bias of .06 L/min/m(2) +/- .4 L/min/m(2). Paired measurements correlated well in both phase I (r = .97, R2 = .95, P < .0001) and phase II (r = .93, R2 = .86, P < .0001) of the study.
CONCLUSIONS: Doppler UTS correlates well with PAC measurements of CI. This noninvasive modality is an accurate and safe alternative to PAC.
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