[Non-invasive Doppler-ultrasound determination of cardiac output. Results and experiences with the ACCUCOM]. / Nicht-invasive Doppler-Ultraschallmessung des Herzzeitvolumens. Ergebnisse und Erfahrungen mit dem ACCUCOM.

Because of the invasiveness of the method, the determination of cardiac output (CO) by the thermodilution technique is not without a certain risk to the patient. Previous studies have suggested that noninvasive Doppler technology could be used to determine the velocity of blood in the aorta. With knowledge of the diameter of the aorta, CO can be calculated. The newly developed ACCUCOM (Datascope Corp.) measures CO noninvasively by Doppler ultrasound. However, there is not much information as to how the ACCUCOM performs in clinical practice. The present study was designed to compare the determination of CO by the ACCUCOM with that by thermodilution. CO was determined simultaneously in 12 anesthetized patients scheduled for abdominal or orthopedic surgery. There was a significant but not very tight linear correlation (r = 0.82) between ACCUCOM and reference measurements. The ACCUCOM underestimated CO on the average by 32%. In order to analyze the ACCUCOM tracking of relative changes in CO, in 6 out of 12 patients CO was also determined during cardiac stimulation by isoprenaline (0.5-1.0 microgram.min-1) IV. The resulting increase in CO was detected reliably using the ACCUCOM. It was, however, significantly overestimated by the Doppler technique (average increase = 58%) as compared to the reference method (average increase = 42%). These results suggest the possibility of major deviations in determining CO with the ACCUCOM.(ABSTRACT TRUNCATED AT 250 WORDS)