SESSION TYPE: Invasive Procedures and Hemodynamic Monitoring Posters
PRESENTED ON: Wednesday, October 24, 2012 at 01:30 PM - 02:30 PM
PURPOSE: Stroke volume is a parameter that is being recognized as an endpoint in fluid resuscitation algorithm. Direct measurement of stroke volume (SV) and stroke volume variation (SVV) is preferred over mean cardiac output (CO) measurement because it renders a more accurate reflection of hemodynamic status. SVV in response to fluid challenge projects a valid projection into efficacy of intervention. Flo Trac sensor with Vigileo monitor is a system using a complex algorithm to calculate SV, SVV, and CO. Its limitations are: a) it requires placement of an arterial line and, b) it is mainly reliable in mechanically-ventilated patients. An underutilized alternative in hemodynamic assessment is portable echocardiography; it is noninvasive in contrast to Flo Trac-Vigileo; it can also be reliable in ventilated and non-ventilated patients. We assessed the feasibility of SV measurements with a portable echocardiogram and validated its accuracy with the Flo Trac-Vigileo system in mechanically ventilated patients.
METHODS: Ten patients who were on mechanical ventilation were studied. A femoral arterial line was connected to Flo Trac-Vigileo system monitoring SV, SVV, and CO. Sonosite M-turboR portable echocardiogram was used to measure SV. CO was calculated by multiplying SV by heart rate. No patient had any arrhythmia. We used biplane Simpson's Method of Discs to calculate SV in which subtraction of end-systolic volume from end-diastolic volume yields the SV.
RESULTS: The comparison of simultaneous SV and CO measurements by echocardiography with Flo Trac-Vigileo showed a strong correlation between the two (y=0.9545x + 3.3; R2=0.9847).
CONCLUSIONS: In our small cohort, the SV and CO measured by Sonosite echocardiogram appear to be closely correlated to their respective values measured by Flo-Trac Vigileo.
CLINICAL IMPLICATIONS: Sonosite portable echocardiogram is a reliable noninvasive tool in hemodynamic assessment of the critically ill. Its results need further validation with Flo Trac-Vigileo system by a larger cohort of patients. If the correlation stays valid, it can make the Sonosite an attractive tool in assessment of different hemodynamic scenarios in the critically ill.
DISCLOSURE: The following authors have nothing to disclose: Mehrdad Behnia, Sherry Powell, Houman Tammadon, Masud Behnia
We are presenting data on a special portable echocardiogram made by Sonosite Company that can be used in hemodynamic assessment of the critically ill.Doctors Hospital, Augusta, GA