Use of the esophageal echo-Doppler to guide intensive care unit resuscitations: A retrospective study

Purpose: The esophageal Doppler monitoring (EDM) has emerged as an alternative to the pulmonary artery catheter (PAC). The purpose of this study is to better define its role in the ICU. Materials and Methods: Retrospective review of Hemosonic™ 100 EDM probe use between 2003 and 2005. Patient- and EDM-related characteristics, indications, complications, resuscitation end points (lactate, base excess - BE, left ventricular ejection time - LVET) were recorded. Comparisons between EDM and PAC were made. Results: Thirty-nine patients were monitored using the EDM. EDM-guided interventions resulted in significantly improved lactate, BE and LVET (all, P P Conclusions: EDM may be most helpful in ventilated/sedated patients requiring short-term hemodynamic monitoring. When compared to PAC, the EDM tends to underestimate CO in the lower range and overestimate CO in the upper range of measurements. We recommend EDM use concurrently with end-points of resuscitation.

[1]  S. Stawicki,et al.  Hemodynamic Monitoring of Organ Donors: A Novel Use of the Esophageal Echo-Doppler Probe , 2006, The American surgeon.

[2]  W. Hoff,et al.  MOVE OVER, MR SWAN-GANZ: FINDING A PLACE FOR THE ESOPHAGEAL ECHO-DOPPLER IN THE ICU.: 216-S , 2005 .

[3]  W. Hoff,et al.  Use of non-invasive esophageal echo-Doppler system in the ICU: a practical experience. , 2005, The Journal of trauma.

[4]  Taehyung Han.  The esophageal Doppler monitor is useful for fluid management during the perioperative and intensive care periods. , 2005, The Journal of trauma.

[5]  B. Koneru,et al.  Minimally Invasive Optimization of Organ Donor Resuscitation: Case Reports , 2005 .

[6]  T. Han,et al.  Comparison of cardiac outputs of major burn patients undergoing extensive early escharectomy: esophageal Doppler monitor versus thermodilution pulmonary artery catheter. , 2004, The Journal of trauma.

[7]  S. Ahmad,et al.  Use of the Esophageal Doppler and Sublingual Capnometer in the Hemodynamic Assessment of Mechanically Ventilated Surgical Patients , 2004 .

[8]  M. Singer,et al.  The validity of trans-esophageal Doppler ultrasonography as a measure of cardiac output in critically ill adults , 2004, Intensive Care Medicine.

[9]  P. Metnitz,et al.  Improving risk adjustment in critically ill trauma patients: the TRISS-SAPS Score. , 2004, The Journal of trauma.

[10]  P. Angood,et al.  The esophageal Doppler monitor in mechanically ventilated surgical patients: does it work? , 2003, The Journal of trauma.

[11]  W. Hoff,et al.  NOVEL INDICATIONS FOR THE USE OF A NON-INVASIVE ESOPHAGEAL ECHO-DOPPLER SYSTEM IN THE ICU: 301 , 2002 .

[12]  K. Laupland,et al.  Utility of esophageal Doppler as a minimally invasive hemodynamic monitor: a review , 2002, Canadian journal of anaesthesia = Journal canadien d'anesthesie.

[13]  M. de Swiet,et al.  A comparison of hemodynamic data derived by pulmonary artery flotation catheter and the esophageal Doppler monitor in preeclampsia. , 2000, American journal of obstetrics and gynecology.

[14]  P. Marik.  Pulmonary artery catheterization and esophageal doppler monitoring in the ICU. , 1999, Chest.

[15]  H Belzberg,et al.  Multicenter study of noninvasive monitoring systems as alternatives to invasive monitoring of acutely ill emergency patients. , 1998, Chest.

[16]  G. Bernardin,et al.  Continuous noninvasive measurement of aortic blood flow in critically ill patients with a new esophageal echo-Doppler system. , 1998, Journal of critical care.

[17]  J. E. de la Coussaye,et al.  Noninvasive monitoring of cardiac output in critically ill patients using transesophageal Doppler. , 1998, American journal of respiratory and critical care medicine.

[18]  L. Goldman,et al.  The effectiveness of right heart catheterization in the initial care of critically ill patients. SUPPORT Investigators. , 1996, JAMA.

[19]  M. Singer.  Esophageal Doppler Monitoring of Aortic Blood Flow: Beat‐by-Beat Cardiac Output Monitoring , 1993, International anesthesiology clinics.