COMPARISON OF ECHOCARDIOGRAPHIC ASSESSMENT OF CARDIAC HEMODYNAMICS INTHE INTENSIVE-CARE UNIT WITH RIGHT-SIDED CARDIAC-CATHETERIZATION

Estimation of left ventricular filling pressure and cardiac index is i mportant in the management of patients requiring right heart catheteri zation. Doppler echocardiography can provide a noninvasive measure of these parameters, but its accuracy in individual measurements, predict ing hemodynamic subgroups, and in tracking serial changes in criticall y ill patients remains to be elucidated. Left ventricular filling pres sure and cardiac index were assessed in 49 critically ill patients req uiring right heart catheterization and Doppler echocardiographic studi es. Two or more serial studies were performed in 18 of these subjects, patients were placed into 1 of 4 hemodynamic subgroups for each techn ique based on the acquired hemodynamic parameters. Left ventricular fi lling pressure and cardiac index by Doppler echocardiography and right heart catheterization were similar (21 +/- 8 vs 20 +/- 8 mm Hg; 3.0 /- 1.2 vs 2.9 +/- 1.2 L/min/m(2), respectively) and correlated well wi th each other (left ventricular filling pressure, r = 0.88; cardiac in dex, r = 0.92). The Doppler technique accurately placed 73 of 76 studi es into the correct hemodynamic subgroup. The noninvasive technique al so reliably tracked serial hemodynamic measurements, We conclude that Doppler echocardiography accurately assesses left heart hemodynamics i n critically ill patients. Since this technique can be readily acquire d, it can be ideal for the rapid assessment of hemodynamic parameters in critically ill patients, especially when right heart catheterizatio n is delayed or is problematic.