Noninvasive Doppler ultrasonography for assessing cardiac function: can it replace the Swan-Ganz catheter?

Abstract

Background Cardiac function, including cardiac index (CI), traditionally has been measured by a pulmonary artery catheter (PAC). A noninvasive alternative for measuring cardiac function would offer obvious advantages. Methods A prospective study of trauma and nontrauma patients was performed in a surgical intensive care unit over a 3-month period. CI was determined using both a standard PAC and a continuous-wave Doppler ultrasound (UTS). The study had 2 phases: phase I was nonblinded and phase II was blinded; the correlation between UTS- and PAC-derived CI was assessed. Results A total of 120 paired measurements of CI were observed in 31 patients. The UTS-derived CI measurements showed agreement with PAC measurements in both phase I and phase II of the study with a bias of .06 L/min/m 2 ± .4 L/min/m 2. Paired measurements correlated well in both phase I ( r = .97, R2 = .95, P < .0001) and phase II ( r = .93, R2 = .86, P < .0001) of the study. Conclusions Doppler UTS correlates well with PAC measurements of CI. This noninvasive modality is an accurate and safe alternative to PAC.