Comparação dos valores de débito cardíaco obtidos por termodiluição e dopplerfluxometria transesofágica

• Autor(a) principal: Ferreira, Roberto Manara Victorio [UNIFESP]
• Data de Publicação: 2007
• Outros Autores: Amaral, José Luiz Gomes do [UNIFESP], Valiatti, Jorge Luís dos Santos [UNIFESP]
• Tipo de documento: Artigo
• Idioma: por
• Título da fonte: Repositório Institucional da UNIFESP
• Texto Completo: http://dx.doi.org/10.1590/S0104-42302007000400022; http://repositorio.unifesp.br/handle/11600/3821
• topic: Oesophageal echocardiography; Thermodilution; Peripheral vascular resistance; Cardiac output; Cardiac index; Hemodynamic monitoring; Ecocardiografia transesofagiana; Termodiluição; Resistência vascular periférica; Débito cardíaco; Índice cardíaco; Processos hemodinâmicos

OBJECTIVES: Thermodilution (TD) is the gold standard method for hemodynamic monitoring. Some parameters can be measured by Oesophageal Doppler (OD), which is simpler and less invasive. To evaluate the accuracy of OD, we compared this method with TD in measurement of cardiac output (CO). METHODS: One hundred and ninety two simultaneous measurements were made in 10 patients (5 male and 5 female) with different clinical situations, 8 with sepsis using vasoactive drugs and 2 monitored for laryngectomy and liver transplantation. Measurements were taken during 4 hours at 30 minute intervals. The two oesophageal dopplers used DeltexR and ArrowR, were introduced between 35 and 45 cm from the nose and located at the point of largest diameter of the descending aorta. In TD, we used the pulmonary artery catheter (Swan Ganz BaxterR) and the DX- 2001 monitorR positioning was confirmed with support of radiology and of pressures curves. Measurements of CO carried out by means of TD were achieved using an iced saline solution considering the mean of four measurements with less than a 5% difference. The statistical method used was the Bland-Altman scatter plot and dispersion graphic. RESULTS: No statistically significant difference was found between the two methods for hemodyamic measurement with a correlation coefficient of 0.8 for CO (Deltex DopplerR and Baxter Swan GanzR) and a correlation coefficient of 0.99 for CO (Arrow DopplerR and Baxter Swan GanzR). CONCLUSION: Homodynamic measurements with OD have the same accuracy as those with TD and were easily obtained in the 10 patients.