Continuous Noninvasive Aortic Blood Flow Monitoring

  • M. Singer


Haemodynamic monitoring in both operating theatre and intensive care environments remains predominantly pressure-based even though these variables are well recognised as coarse, non-specific and generally late indicators of cardiovascular deterioration. The sensitivity of pressure measurements in detecting changes in flow and ventricular end-diastolic volumes are undermined further by changes in body temperature, ventricular compliance, volaemic status and reflex vasoconstriction. A normal blood pressure frequently masks an inadequate cardiac output while severe hypovolemia may be present despite normal or even elevated central venous pressures.


Left Ventricular Filling Waveform Shape Stroke Distance Flow Velocity Waveform Elevated Central Venous Pressure 
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  1. 1.
    Campling EA, Devlin HB, Hoile RW, Lunn JN (1993) National confidential enquiry into perioperative deaths 1991/1992, HMSO, LondonGoogle Scholar
  2. 2.
    Singer M, Bennett ED (1989) Invasive hemodynamic monitoring in the United Kingdom. Enough or too litüe? Chest 95:623–626PubMedCrossRefGoogle Scholar
  3. 3.
    Shoemaker WC, Appel PL, Kram HB, Waxman K, Lee T-S (1988) Prospective trial of supranormal values of survivors as therapeutic goals in high-risk surgical patients. Chest 94:1176–1186PubMedCrossRefGoogle Scholar
  4. 4.
    Boyd O, Grounds RM, Bennett ED (1993) A randomised clinical trial of the effect of deliberate perioperative increase of oxygen delivery on mortality in high-risk surgical patients. JAMA 270:2699–2707PubMedCrossRefGoogle Scholar
  5. 5.
    Hayes MA, Timmins AC, Yau EH, Palazzo M, Hinds CJ, Watson D (1993) Elevation of systemic oxygen delivery in the treatment of critically ill patients. N Engl J Med 330: 1717–1722CrossRefGoogle Scholar
  6. 6.
    Light LH (1969) Non-injurious ultrasonic technique for observing flow in the human aorta. Nature 224:1119–1121PubMedCrossRefGoogle Scholar
  7. 7.
    Light LH (1976) Transcutaneous aortovelography. A new window on the circulation? Br Heart J 38:433–442PubMedCrossRefGoogle Scholar
  8. 8.
    Huntsman LL, Stewart DK, Barnes SR, Franklin SB, Colocousis JS, Hessel EA (1983) Noninvasive Doppler determination of cardiac output in man. Circulation 67:593–602PubMedCrossRefGoogle Scholar
  9. 9.
    Chandraratna PA, Nanna M, McKay C et al (1984) Determination of cardiac output by transcutaneous continuous-wave ultrasonic Doppler computer. Am J Cardiol 53:234–237PubMedCrossRefGoogle Scholar
  10. 10.
    Christie J, Sheldahl LM, Tristani FE, Sagar KB, Ptacin MJ, Wann S (1987) Determination of stroke volume and cardiac output during exercise: comparison of two-dimensional and Doppler echocardiography, Eick oximetry, and thermodilution. Circulation 76:539–547PubMedCrossRefGoogle Scholar
  11. 11.
    Side CD, Gosling RJ (1971) Non-surgical assessment of cardiac function. Nature 232:335–336PubMedCrossRefGoogle Scholar
  12. 12.
    Olson M, Cooke JP (1974) A nondestructive ultrasonic technique to measure diameter and blood flow in arteries. IEEE Trans Biomed Eng 168–171Google Scholar
  13. 13.
    Duck FA, Hodson CJ, Tomlin PJ (1974) An esophageal Doppler probe for aortic flow velocity monitoring. Ultrasound Med Biol 1:233–241PubMedCrossRefGoogle Scholar
  14. 14.
    Daigle RE, Miller CW, Histand MB, McLeod FD, Hokanson D (1975) Nontraumatic aortic blood flow sensing by use of an ultrasonic esophageal probe. J Appl Physiol 38:1153–1160PubMedGoogle Scholar
  15. 15.
    Lavandier B, Cathignol D, Muchada R, Bui Xuan B, Motin J (1985) Noninvasive aortic blood flow measurement using an intraesophageal probe. Ultrasound Med Biol 11:451–460PubMedCrossRefGoogle Scholar
  16. 16.
    Mark NB, Steinbrook RA, Gugino LD, Madi R, Hartwell B, Shemin R (1986) Continuous noninvasive monitoring of cardiac output with esophageal Doppler ultrasound during cardiac surgery. Anesth Analg 65:1013–1020PubMedCrossRefGoogle Scholar
  17. 17.
    Stein MS, Barratt SMcG, Purcell GJ (1991) Intraoperative assessment of the Lawrence 3000 Doppler cardiac output monitor. Anaesth Intensive Care 251–255Google Scholar
  18. 18.
    Singer M, Clarke J, Bennett ED (1989) Continuous hemodynamic monitoring by esophageal Doppler. Crit Care Med 17:447–52PubMedCrossRefGoogle Scholar
  19. 19.
    Lefrant JY, de la Coussaye JE, Bassoul B, Auffray JP, Eledjam JJ (1992) Comparison of cardiac output measured by esophageal Doppler vs thermodilution. Intensive Care Med 18 [Suppl 2]:P238Google Scholar
  20. 20.
    Belot JP, Valtier B, de la Coussaye JE, Mottin D, Payen D (1992) Continuous estimation of cardiac output in critically ill mechanically ventilated patients by a new transoesophageal Doppler probe. Intensive Care Med 18 [Suppl 2]:P241Google Scholar
  21. 21.
    Klotz K-F, Klingsiek S, Singer M et al (1995) Continuous measurement of cardiac output during aortic cross-clamping by the oesophageal Doppler monitor ODM 1. Br J Anaesth 74:655–660PubMedCrossRefGoogle Scholar
  22. 22.
    Murdoch IA, Marsh MJ, Tibby SM, McLuckie A (1995) Continuous haemodynamic monitoring in children: use of transoesophageal Doppler. Acta Paediatr 84:761–764PubMedCrossRefGoogle Scholar
  23. 23.
    Singer M, Allen MJ, Webb AR, Bennett ED (1991) Effects of alterations in left ventricular filling, contractility, and systemic vascular resistance on the ascending aortic blood velocity waveform of normal subjects. Crit Care Med 19:1138–1145PubMedCrossRefGoogle Scholar
  24. 24.
    Singer M, Bennett ED (1991) Non-invasive optimization of left ventricular filling by esophageal Doppler. Crit Care Med 19:1132–1137PubMedCrossRefGoogle Scholar
  25. 25.
    Bazett MC (1920) An analysis of the time-relations of electrocardiograms. Heart 7:353–364Google Scholar
  26. 26.
    Singer M, Bennett ED (1989) Pitfalls of pulmonary artery catheterisation highlighted by Doppler ultrasound. Crit Care Med 17:1060–1061PubMedCrossRefGoogle Scholar
  27. 27.
    Singer M, Bennett ED (1989) Optimisation of positive end-expiratory pressure for maximal delivery of oxygen to tissues by using oesophageal Doppler ultrasonography. Br Med J 298:1350–1353CrossRefGoogle Scholar
  28. 28.
    Patel M, Singer M (1993) When should the cardiorespiratory effects of PEEP be measured? Chest 104:139–142PubMedCrossRefGoogle Scholar
  29. 29.
    Singer M, Vermaat J, Hall G, Latter G, Patel M (1994) Hemodynamic effects of hyperinflation in critically ill mechanically ventilated patients. Chest 106:1182–1187PubMedCrossRefGoogle Scholar
  30. 30.
    Evans JWH, Singer M, Chappie CR, Macartney N, Walker JM, Milroy EJ (1992) Haemodynamic evidence for cardiac stress during transurethral prostatectomy. Br Med J 304:666–671CrossRefGoogle Scholar
  31. 31.
    Evans JWH, Singer M, Coppinger SWV, Macartney N, Walker JM, Milroy EJG (1994) Cardiovascular performance and core temperature during transurethral prostatectomy. J Urol 152:2025–2029PubMedGoogle Scholar
  32. 32.
    Mythen MG, Webb AR (1995) Perioperative plasma volume expansion reduces the incidence of gut mucosal hypoperfusion during cardiac surgery. Arch Surg 130:423–429PubMedCrossRefGoogle Scholar
  33. 33.
    Mythen MG, Webb AR (1994) Intraoperative gut mucosal hypoperfusion is associated with increased post-operative complications and cost. Intensive Care Med 20:99–104PubMedCrossRefGoogle Scholar

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© Springer-Verlag Italia, Milano 1996

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  • M. Singer

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