PMID- 9609413
OWN - NLM
STAT- MEDLINE
DCOM- 19980716
LR  - 20230320
IS  - 0342-4642 (Print)
IS  - 0342-4642 (Linking)
VI  - 24
IP  - 4
DP  - 1998 Apr
TI  - Training is required to improve the reliability of esophageal Doppler to measure 
      cardiac output in critically ill patients.
PG  - 347-52
AB  - OBJECTIVES: Assessment of and effect of training on reliability of esophageal 
      Doppler (ED) versus thermodilution (TD) for cardiac output (CO) measurement. 
      DESIGN: Prospective study. SETTING: Intensive care unit of a university hospital. 
      PATIENTS: 64 consecutive critically ill patients requiring a pulmonary artery 
      catheter, sedation, and mechanical ventilation. INTERVENTIONS: Esophageal Doppler 
      CO measurements were performed by the same operator, whereas TD CO measurements 
      were carried out by other independent operators. A training period involving the 
      first 12 patients made the operator self-confident. In the remaining patients, 
      the reliability of ED was assessed (evaluation period), using correlation 
      coefficients and the Bland and Altman diagram. Between training and evaluation 
      periods, correlation coefficients, biases, and limits of agreement were compared. 
      MEASUREMENTS AND RESULTS: During training and evaluation periods, 107 and 320 CO 
      measurements were performed in 11 out of 12 patients and in 49 out of 52 
      patients, respectively. Continuous CO monitoring was achieved in 6 out of 11 
      patients and in 38 out of 49 patients during training and evaluation periods, 
      respectively. Between the two periods, correlation coefficients increased from 
      0.53 to 0.89 (p < 0.001), bias decreased from 1.2 to 0.1 l x min(-1) (p < 0.001), 
      and limits of agreement decreased from 3.2 to 2.2 l x min(-1) (p < 0.001). 
      CONCLUSION: A period of training involving no more than 12 patients is probably 
      required to ensure reliability of CO measurement by ED.
FAU - Lefrant, J Y
AU  - Lefrant JY
AD  - Departement d'Anesthesie-Reanimation, Centre Hospitalier Universitaire de Nimes, 
      France.
FAU - Bruelle, P
AU  - Bruelle P
FAU - Aya, A G
AU  - Aya AG
FAU - Saissi, G
AU  - Saissi G
FAU - Dauzat, M
AU  - Dauzat M
FAU - de La Coussaye, J E
AU  - de La Coussaye JE
FAU - Eledjam, J J
AU  - Eledjam JJ
LA  - eng
PT  - Comparative Study
PT  - Journal Article
PL  - United States
TA  - Intensive Care Med
JT  - Intensive care medicine
JID - 7704851
SB  - IM
MH  - Aged
MH  - Bias
MH  - *Cardiac Output
MH  - Clinical Competence/*standards
MH  - Critical Care
MH  - Critical Illness
MH  - Echocardiography, Doppler/*standards
MH  - Echocardiography, Transesophageal/*standards
MH  - Female
MH  - Humans
MH  - Linear Models
MH  - Male
MH  - Middle Aged
MH  - Personnel, Hospital/*education
MH  - Prospective Studies
MH  - Reproducibility of Results
MH  - Thermodilution/*standards
EDAT- 1998/06/03 00:00
MHDA- 1998/06/03 00:01
CRDT- 1998/06/03 00:00
PHST- 1998/06/03 00:00 [pubmed]
PHST- 1998/06/03 00:01 [medline]
PHST- 1998/06/03 00:00 [entrez]
AID - 10.1007/s001340050578 [doi]
PST - ppublish
SO  - Intensive Care Med. 1998 Apr;24(4):347-52. doi: 10.1007/s001340050578.