Comparison between ultrasonic and thermodilution cardiac output measurements in intensive care patients

Abstract

The reliability of ultrasonic cardiac output measurement was assessed using a commercial device that combines A-mode aortic root diameter determination and continuous wave (CW) Doppler flow velocity measurement in the ascending aorta. We compared this method with thermodilution (TD) cardiac output in 41 intensive care patients. Aortic root diameter measurement with A-mode was not possible in four (10%) patients. Using strictly defined criteria based upon our initial experience, we could not obtain acceptable CW Doppler flow signals in nine (22%) patients. Thus, ultrasonic cardiac output measurement was possible in 28 (68%) patients in whom there was an excellent correlation with cardiac output (r = 0.97; p less than .001). This study demonstrates that the transcutaneous CW Doppler method for measuring cardiac output is accurate and reliable in a limited percentage of ICU patients. Combining the CW Doppler with B-mode echocardiogram increases the applicability when an A-mode measurement is not possible.