• A K Madan, V V UyBarreta, S Aliabadi-Wahle, R Jesperson, R S Hartz, L M Flint, and S M Steinberg.
• Department of Surgery, Tulane University School of Medicine, New Orleans, Louisiana, USA.
• J Trauma. 1999 Apr 1;46(4):607-11; discussion 611-2.

BackgroundThe pulmonary artery (PA) catheter has been used to determine hemodynamic indices; however, it has recently been criticized. This study was undertaken to evaluate an esophageal Doppler monitor (EDM) as a possible replacement for PA catheter in critically ill, mechanically ventilated patients.MethodsEDM and PA catheters were placed in patients in the surgical intensive care units (n = 14, 118 matched sets of data). PA catheter and EDM measurements, including corrected flow time (FTc,) a measure of preload, were obtained. Pearson correlation (r) was analyzed to compare PA catheter and EDM measurements, and a nonlinear regression model was used to describe Starling Relationships.ResultsCardiac output correlated between EDM and PA catheter (r = 0.6; p < 0.001). FTc correlated more strongly with cardiac output than did pulmonary capillary wedge pressure. (FTc: r2 = 0.27; p < 0.001; cardiac output: r2 = 0.04; p = 0.06).ConclusionCorrected flow time is a better indicator of preload than pulmonary capillary wedge pressures. EDM seems to be at least as useful as PA catheter in managing the hemodynamic status of critically ill surgical patients.

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