Clinical evaluation of USCOM ultrasonic cardiac output monitor in cardiac surgical patients in intensive care unit

Abstract

The USCOM monitor has a place in intensive care monitoring. It is accurate, rapid, safe, well-tolerated, non-invasive and cost-effective. The learning curve for skill acquisition is very short. However, during the learning phase the USCOM monitor measurements are rather 'operator dependent'. Its suitability for use in high and low cardiac output states requires further validation.

Cardiac Output Measurement Using a Modified Carbon Dioxide Fick Method: A Validation Study in Ventilated Lambs

“…These methods differ in applicability due to technical and size constraints and reliability (1)(2)(3). In comparison with published data concerning bias and precision of several methods of cardiac output measurement in animals (19 -22), children (23)(24)(25)(26)(27)(28)(29)(30), and adults (31)(32)(33)(34)(35)(36)(37)(38), this study produced favorable results.…”

Hemodynamic monitoring by USCOM during rapid sequence intubation (RSI) with Etomidate/Fentanyl or Ketamine/Midazolam

“…Patients in our study for instance, were ventilated mechanically post-RSI which contributes to difficulties in CO measurements by an ultrasound-based device. Moreover, some studies indicated that USCOM tends to underestimate the real CO value when it is relatively high [16][17][18]. On the contrary, such a difference does not appear in Su et al's research [17,18].…”

“…The technique is reported to be easily learned after a short period by non-physicians [29,30]. Previously reported trials investigated the accuracy of USCOM in various settings and most of them found an acceptable agreement between the USCOM CO measurements and those determined by a thermodilution-based method [15,29,22,[31][32][33][34]16,35,20]. Although, it is critical to report, that an inferior accuracy for USCOM was reported by other authors who found that CO measurements by USCOM do not reliably represent absolute values as compared to pulmonary artery catheter thermodilution technique [36,35].…”

“…However, arrhythmia, infection and possible pulmonary artery disruption have always been concerns related to the use of a PAC and led to a growing interest in the development of non-invasive hemodynamic monitoring devices [11][12][13]. One less invasive thermodilution-based technique consists of the pulse induced cardiac output device (PiCCO) but exclusively ultrasound-based devices as the USCOM monitor are entirely non-invasive methods for measuring CO [14][15][16][17][18][19][20]. Beside accuracy and the method related risks another crucial criterion consists of the time required for the determination of CO [21].…”

Cardiac output monitoring: basic science and clinical application

“…Because these measurements are taken from the aortic root, the technique is not affected by changes in distribution of cardiac output between the upper and lower body. Cardiac output measurements taken using the supra-sternal Doppler method were similar to those taken with an electromagnetic aortic flow probe in an animal study [73], and with pulmonary artery catheter thermodilution in clinical studies [74][75][76]. The portable and non-invasive nature of this technology is a major advantage, allowing use in any clinical setting.…”