Noninvasive cardiac output monitoring by aortic blood flow determination : Evaluation of the Sometec Dynemo-3000 system

摘要: OBJECTIVE The Sometec Dynemo-3000 system allows the permanent measurement of descending aorta diameter by an echographic (A-scan) device and blood flow velocity a pulse Doppler velocimeter. then furnishes new hemodynamic parameter, i.e., aortic (ABF), which is fraction cardiac output (CO). We evaluate ability this to measure accurately detect ABF changes. DESIGN A case study prospective trial. SETTING 24-bed medical intensive care unit 1,100-bed university hospital. PATIENTS Twenty critically ill patients fully sedated, mechanically ventilated, monitored pulmonary artery catheter. INTERVENTIONS CO values determined conventional thermodilution method (TD-CO) were recorded during study, included two initial baseline periods, dobutamine infusion (5 microg/kg/min) interval 30 mins, third period. To assess accuracy A-scan, was measured transesophageal echocardiography. difference between echocardiography A-scan used determine bias precision for measurements. TD-CO variations analyzed using Kruskal-Wallis Wilcoxon tests. Association calculating linear correlation coefficient. >6.0 L/min its >13% determination sensitivity, specificity, positive (PPV) negative (NPV) predictive values. MEASUREMENTS AND MAIN RESULTS Aortic measurements bidimensional methods 23.0+/-2.8 mm (SD) 24.2+/-2.7 mm, respectively. Bias 1.1 1.4 (95% confidence interval: -1.9 3.7), During course infusion, we observed significant increase mean value from 6.65+/-1.53 9.30+/-2.5 (p=.0008), parallel in 4.34+/-1.18 5.70+/-1.63 (p= .0029). Absolute had coefficient 0.80. For detection increased TD-CO, PPV NPV 87% 86%, changes >13%, 80% 94%, CONCLUSIONS able display real diameter, one most important components noninvasive ultrasonic technique. When compared with provided constitutes reliable tool estimating tracking