CARDIAC-OUTPUT MONITORING BY ECHOCARDIOGRAPHY - SHOULD WE PASS ON SWAN-GANZ CATHETERS

Transesophageal echocardiography offers a noninvasive technique for th e continuous monitoring of cardiac performance. The combination of 2-d imensional echocardiography and Doppler velocitometry provide assessme nt of cardiac anatomy, valve function and, ventricular loading conditi ons. Although transesophageal echocardiography has become accepted for perioperative monitoring, it is typically used in conjunction with Sw an-Ganz catheterization. To supplant Swan-Ganz catheters, an echocardi ographic technique to monitor cardiac output is necessary. Despite con siderable effort to achieve this goal, a satisfactory technique has be en difficult to realize. This paper discusses the role of cardiac outp ut monitoring in perioperative care and critically examines echocardio graphic techniques for cardiac output monitoring.