CO assessment by suprasternal Doppler in critically ill patients: comparison with thermodilution

Abstract

Objective: Comparison of suprasternal Doppler (SST) and thermodilution (TD) for the measurement of cardiac output (CO) in critically ill patients.¶Design: Prospective study.¶Setting: Intensive care unit of a university hospital.¶Patients and participants: 65 consecutive critically ill patients requiring a pulmonary artery catheter.¶Interventions: Paired CO measurements were made simultaneously using SST and TD by two independent operators. The time to obtain a CO value by SST was measured. Correlation coefficients and the linear regression equation were determined. A Bland and Altman diagram was plotted. A Bland and Altman diagram was also plotted for the level of cardiac index (CI) values (low: CI < 2.5 l min^–1 m^–2; normal: 2.5 ≤ CI ≤ 4.5 l min^–1 m^–2; high: CI > 4.5 l min^–1 m^–2).¶Measurements and results: In seven patients SST failed to measure CO. In the remaining 58 patients 314 paired CO measurements were performed. The mean time to measure CO by SST was 73 ± 45 s. The equation of linear regression was: SST_CO = 0.84 TD_CO + 1.39. The correlation coefficient was 0.84. The bias between SST and TD was –0.2 ± 1.4 l min^–1. Biases were –0.23 ± 0.50, –0.20 ± 0.68, and 0.25 ± 0.92 l min^–1 m^–2 for low, normal, and high levels of CI, respectively.¶Conclusion: SST does not accurately measure CO but allows a rapid assessment of CI level in critically ill patients.