PMID- 11573585
OWN - NLM
STAT- MEDLINE
DCOM- 20011011
LR  - 20190515
IS  - 0007-0912 (Print)
IS  - 0007-0912 (Linking)
VI  - 86
IP  - 6
DP  - 2001 Jun
TI  - Oesophageal Doppler monitoring overestimates cardiac output during lumbar 
      epidural anaesthesia.
PG  - 794-7
AB  - Oesophageal Doppler monitoring (ODM) has been advocated as a non-invasive means 
      of measuring cardiac output (CO). However, its reliance upon blood flow 
      measurement in the descending aorta to estimate CO is susceptible to error if 
      blood flow is redistributed between the upper and lower body. We hypothesize that 
      lumbar epidural anesthesia (LEA), which causes blood flow redistribution, causes 
      errors in CO estimates. We compared ODM with thermodilution (TD) measurements in 
      fourteen patients under general anaesthesia for radical prostatectomy, who had 
      received an epidural catheter at the intervertebral level L2-L3. Coupled 
      measurements of CO by means of the TD and ODM techniques were performed at 
      baseline (general anaesthetic only) and after epidural administration of 10 ml of 
      0.25% bupivacaine. The two methods were compared using Bland-Altman analysis: 
      before LEA there was a bias of -0.89 litre min(-1) with limits of agreement 
      ranging between -2.67 and +0.88 litre min(-1). Following lumbar sympathetic 
      block, bias became positive (+0.55 litre min(-1)) and limits of agreement 
      increased to -3.21 and +4.30 litre min(-1). ODM measured a greater increase in CO 
      after LEA (delta=+1.71 (1.19) litre min(-1) (mean (SD)) compared with TD 
      (delta=+0.51 (0.70) litre min(-1)). We conclude that following LEA, measurements 
      with the Oesophageal Doppler Monitor II overestimate CO and show unacceptably 
      high variability. Blood flow redistribution may limit the value of ODM.
FAU - Leather, H A
AU  - Leather HA
AD  - Department of Anaesthesiology, University Hospitals, Katholieke Universiteit 
      Leuven, U. Z. Gasthuisberg, Leuven, Belgium.
FAU - Wouters, P F
AU  - Wouters PF
LA  - eng
PT  - Journal Article
PL  - England
TA  - Br J Anaesth
JT  - British journal of anaesthesia
JID - 0372541
RN  - 0 (Anesthetics, Combined)
RN  - 7E4PHP5N1D (Vecuronium Bromide)
RN  - AFE2YW0IIZ (Sufentanil)
RN  - YI7VU623SF (Propofol)
SB  - IM
MH  - Aged
MH  - *Anesthesia, Epidural
MH  - Anesthetics, Combined
MH  - Blood Pressure/drug effects
MH  - *Cardiac Output/drug effects
MH  - *Echocardiography, Transesophageal
MH  - Humans
MH  - Lumbosacral Region
MH  - Male
MH  - Middle Aged
MH  - Propofol
MH  - Sensitivity and Specificity
MH  - Sufentanil
MH  - Vecuronium Bromide
EDAT- 2001/09/28 10:00
MHDA- 2001/10/12 10:01
CRDT- 2001/09/28 10:00
PHST- 2001/09/28 10:00 [pubmed]
PHST- 2001/10/12 10:01 [medline]
PHST- 2001/09/28 10:00 [entrez]
AID - S0007-0912(17)36364-X [pii]
AID - 10.1093/bja/86.6.794 [doi]
PST - ppublish
SO  - Br J Anaesth. 2001 Jun;86(6):794-7. doi: 10.1093/bja/86.6.794.