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British Journal of Anaesthesia, Vol 77, Issue 3 365-369, Copyright © 1996 by The Board of Management and Trustees of the British Journal of Anaesthesia

CLINICAL INVESTIGATIONS

On-line estimation of left ventricular stroke volume using transoesophageal echocardiography and acoustic quantification

C. A. Greim, N. Roewer, G. Laux and J. Schulte am Esch
Department of Anaesthesiology, University Hospital of Wurzburg, Josef-Schneider-Str.Z, D-97080, Wurzburg, Germany; Department of Anaesthesiology, University Hospital Eppendorf, Martinistrasse 52, D-20246 Hamburg, Germany

We have examined the usefulness of transoesophageal echocardiography (TOE) and automated endocardium detection for on-line calculation of left ventricular stroke volume. In 12 of 15 patients undergoing abdominal surgery, stroke volume was derived continuously from the multiple discs (MD) and area-length (AL) methods and compared with stroke volume calculated by thermodilution. In 10 patients (80%), more than three manipulations of the ultrasound transducer were required before measurements. Linear regression analysis of automated TOE methods and thermodilution revealed weak correlations (r < 0.75) for stroke volume (114 matched pairs) and its changes (105 matched pairs). Correlation of percentage changes in stroke volume calculated by thermodilution with those derived from MD (r = 0.85) and AL (r = 0.79) was better. Changes in MD (AL) derived stroke volume by more than 20% identified changes in thermodilution-derived stroke volume greater than 20% (n = 57) with a sensitivity of 74% (70%) and a specificity of 82% (79%). Signal instability, lack of accuracy and only a moderate trend capability currently limit the intraoperative usefulness of automated TOE techniques for continuous estimation of stroke volume from a single long-axis plane.
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