Comparison of Transesophageal Doppler Monitor vs. Pulmonary Artery Catheter in the Hemodynamic Indices of Major Burn Patients Undergoing an Extensive Escharectomy.

Kim,  Hyun Soo; Han,  Tae Hyung; Choi,  Man Sik; Son,  Min Jae; Kwok,  In Suk; Wie,  Hee Wook; Kim,  Kwang Min

doi:2002.43.3.274

Clinical Research Article

Korean Journal of Anesthesiology 2002;43(3):274-280.
DOI: https://doi.org/10.4097/kjae.2002.43.3.274

Comparison of Transesophageal Doppler Monitor vs. Pulmonary Artery Catheter in the Hemodynamic Indices of Major Burn Patients Undergoing an Extensive Escharectomy.

Hyun Soo Kim, Tae Hyung Han, Man Sik Choi, Min Jae Son, In Suk Kwok, Hee Wook Wie, Kwang Min Kim

¹Department of Anesthesiology and Pain Medicine, HanGang Sacred Heart Hospital, Hallym University, School of Medicine, Korea. athan@unitel.co.kr
²Department of Anesthesiology and Pain Medicine, Kangbuk Samsung Hospital, Sungkyunkwan University, School of Medicine, Korea.

Abstract

BACKGROUND
In major burn patients, many invasive monitors including a pulmonary artery catheter (PAC) are often required to assess hemodynamic status. An esophageal Doppler monitor (EDM), as a noninvasive method of measuring hemodynamic parameters, may be a substitute for a PAC in this clinical circumstance. This study was conducted to evaluate the validity of Doppler derived hemodynamic indices in comparison to that of a PAC.
METHODS
A total of 20 critically ill, severe burn patients, scheduled for an elective escharectomy and application of artificial dermis, were enrolled for the placement of a PAC and EDM. Simultaneous data was collected in regular intervals and the various parameters were compared between the two methods.
RESULTS
A total of 158 pairs of data in 20 patients were gathered. Among all the parameters, cardiac output (CO) and stroke volume (SV) showed consistently 20% less in EDM. Correlation coefficients of heart rate (HR), CO, SV and systemic vascular resistance (SVR) were 0.97, 0.54, 0.62, and 0.68 respectively. Corrected flow time (FTc) had poor correlations with central venous pressure (CVP) and pulmonary capillary wedge pressure (PCWP). In the mean time, significant, but very weak correlations with FTc vs. CO and SV were demonstrated.
CONCLUSIONS
EDM may be a substitute for a thermodilution (TD) PAC technique, it can be used with usefulness for hemodynamic and preload assessment in major burn patients.

Key Words: Hemodynamics; pulmonary artery catheter; transesophageal Doppler