Noninvasive Doppler ultrasonography for assessing cardiac function: can it replace the Swan-Ganz catheter?

Am J Surg. 2008 Dec;196(6):961-7; discussion 967-8. doi: 10.1016/j.amjsurg.2008.07.039.

Abstract

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.

Publication types

  • Clinical Trial, Phase I
  • Clinical Trial, Phase II
  • Comparative Study
  • Randomized Controlled Trial

MeSH terms

  • Adolescent
  • Adult
  • Catheterization, Swan-Ganz / methods*
  • Child
  • Critical Illness / therapy*
  • Female
  • Follow-Up Studies
  • Humans
  • Intensive Care Units
  • Male
  • Prospective Studies
  • ROC Curve
  • Ultrasonography, Doppler / methods*
  • Ventricular Function / physiology*
  • Young Adult