Circulation, Vol 67, 593-602, Copyright © 1983 by American Heart Association
LL Huntsman, DK Stewart, SR Barnes, SB Franklin, JS Colocousis and EA Hessel
A noninvasive technique for assessing cardiac output (CO) was evaluated by
comparing it with thermodilution determinations in patients in the
intensive care unit. The new method uses pulsed ultrasound to measure
aortic diameter and continuous-wave Doppler ultrasound to obtain aortic
blood velocity. An initial study evaluating just the velocity measurement
showed that changes of the Doppler index of output (DI) correlated well
with those of thermodilution cardiac output (TDCO). Linear regression
analysis yielded delta DI = 0.87 delta TDCO + 0.14 (r = 0.83, n = 95).
Using a university research instrument these measurements were possible in
54 of 60 patients (90%). A second study using a prototype commercial device
incorporated the diameter measurement. Ultrasonic cardiac output (UCO),
calculated as the time integral of velocity multiplied by the aortic area,
was compared to TDCO. The data, obtained from 45 of 53 patients (85%), are
described by the linear regression UCO = 0.95TDCO + 0.38 (r = 0.94, n =
110) over a range of 2-11 l/min. Patients with aortic stenosis, aortic
insufficiency or a prosthetic valve have been excluded from the second
study due to conditions likely to violate the assumptions upon which the
calculation of absolute cardiac output is based. These results indicate
that accurate CO can be measured by noninvasive ultrasound in most
patients. The technique may be useful for extended CO monitoring in acute
care patients and for CO assessment in many other types of patients
undergoing diagnostic studies and therapeutic interventions.
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