Korean J Anesthesiol.  2002 Sep;43(3):274-280. 10.4097/kjae.2002.43.3.274.

Comparison of Transesophageal Doppler Monitor vs. Pulmonary Artery Catheter in the Hemodynamic Indices of Major Burn Patients Undergoing an Extensive Escharectomy

• Kim HS
• Han TH
• Choi MS
• Son MJ
• Kwok IS
• Wie HW
• Kim KM

• KMID: 2238968
• DOI: http://doi.org/10.4097/kjae.2002.43.3.274

Abstract

BACKGROUND: In major burn patients, many invasive monitors including a pulmonary artery catheter (PAC) are often required to assess hemodynamic status. An esophageal Doppler monitor (EDM), as a noninvasive method of measuring hemodynamic parameters, may be a substitute for a PAC in this clinical circumstance. This study was conducted to evaluate the validity of Doppler derived hemodynamic indices in comparison to that of a PAC.
METHODS
A total of 20 critically ill, severe burn patients, scheduled for an elective escharectomy and application of artificial dermis, were enrolled for the placement of a PAC and EDM. Simultaneous data was collected in regular intervals and the various parameters were compared between the two methods.
RESULTS
A total of 158 pairs of data in 20 patients were gathered. Among all the parameters, cardiac output (CO) and stroke volume (SV) showed consistently 20% less in EDM. Correlation coefficients of heart rate (HR), CO, SV and systemic vascular resistance (SVR) were 0.97, 0.54, 0.62, and 0.68 respectively. Corrected flow time (FTc) had poor correlations with central venous pressure (CVP) and pulmonary capillary wedge pressure (PCWP). In the mean time, significant, but very weak correlations with FTc vs. CO and SV were demonstrated.
CONCLUSIONS
EDM may be a substitute for a thermodilution (TD) PAC technique, it can be used with usefulness for hemodynamic and preload assessment in major burn patients.

Keyword

Hemodynamics; pulmonary artery catheter; transesophageal Doppler

MeSH Terms

Burns*
Cardiac Output
Catheters*
Central Venous Pressure
Critical Illness
Dermis
Heart Rate
Hemodynamics*
Humans
Pulmonary Artery*
Pulmonary Wedge Pressure
Stroke Volume
Thermodilution
Vascular Resistance