A comparison of hemodynamic data derived by pulmonary artery flotation catheter and the esophageal Doppler monitor in preeclampsia

OBJECTIVE: This study was undertaken to compare hemodynamic data derived wi th the esophageal Doppler monitor against those obtained with a pulmonary a rtery flotation catheter in women with complicated preeclampsia. STUDY DESIGN: Seventeen women with severe preeclampsia who had a pulmonary artery flotation catheter placed for clinical indications also had an esoph ageal Doppler monitor inserted. Hemodynamic data were recorded on 2 occasio ns separated by several hours with both the pulmonary artery flotation cath eter and the esophageal Doppler monitor simultaneously. RESULTS: The esophageal Doppler monitor underestimated cardiac output by 36 % +/- 14% (mean +/- SD). The esophageal Doppler monitor accurately estimate d cardiac output in 3 women >40 years old, whereas in the remaining women t all <35 years old) the esophageal Doppler monitor underestimated cardiac ou tput by 38% +/- 11%. The esophageal Doppler monitor accurately reflected ch anges in cardiac output with time when compared with the pulmonary artery f lotation catheter. CONCLUSION: In women with preeclampsia the esophageal Doppler monitor consi stently underestimated cardiac output by approximately 40%. It is not known whether the apparent increase in accuracy among the women >40 years old ar ose by chance or reflected a real improvement in performance. The esophagea l Doppler monitor accurately reflected the direction and magnitude of the c hanges in cardiac output with time.