Additional hemodynamic measurements with an esophageal Doppler monitor: a preliminary report of compliance, force, kinetic energy, and afterload in the clinical setting

The esophageal Doppler monitor (EDM) is a minimally-invasive hemodynamic device which evaluates both cardiac output (CO), and fluid status, by estimating stroke volume (SV) and calculating heart rate (HR). The measurement of these parameters is based upon a continuous and accurate approximation of d...

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Bibliographic Details
Published in:Journal of clinical monitoring and computing 2012-12, Vol.26 (6), p.473-482
Main Authors: Atlas, Glen, Brealey, David, Dhar, Sunil, Dikta, Gerhard, Singer, Meryvn
Format: Article
Language:English
Subjects:
Aged
Anesthesiology
Aorta, Thoracic - diagnostic imaging
Blood flow
Blood Volume Determination
Cardiac Output
Compliance
Critical Care Medicine
Doppler effect
Echocardiography, Doppler
Echocardiography, Transesophageal - methods
Electric discharge machining
Health Sciences
Heart Rate
Hemodynamics
Humans
Intensive
Kinetic energy
Male
Mathematical analysis
Medicine
Medicine & Public Health
Middle Aged
Monitoring
Monitoring, Intraoperative
Monitors
Myocardial Contraction
Original Research
Statistics for Life Sciences
Stroke Volume
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Summary:The esophageal Doppler monitor (EDM) is a minimally-invasive hemodynamic device which evaluates both cardiac output (CO), and fluid status, by estimating stroke volume (SV) and calculating heart rate (HR). The measurement of these parameters is based upon a continuous and accurate approximation of distal thoracic aortic blood flow. Furthermore, the peak velocity (PV) and mean acceleration (MA), of aortic blood flow at this anatomic location, are also determined by the EDM. The purpose of this preliminary report is to examine additional clinical hemodynamic calculations of: compliance (C), kinetic energy (KE), force (F), and afterload (TSVR i ). These data were derived using both velocity-based measurements, provided by the EDM, as well as other contemporaneous physiologic parameters. Data were obtained from anesthetized patients undergoing surgery or who were in a critical care unit. A graphical inspection of these measurements is presented and discussed with respect to each patient’s clinical situation. When normalized to each of their initial values, F and KE both consistently demonstrated more discriminative power than either PV or MA. The EDM offers additional applications for hemodynamic monitoring. Further research regarding the accuracy, utility, and limitations of these parameters is therefore indicated.
ISSN:1387-1307
1573-2614
DOI:10.1007/s10877-012-9386-5