Transesophageal Doppler ultrasonography: evidence for improved cardiac output monitoring.

Cardiac output monitoring by transesophageal Doppler ultrasound has not gained wide clinical acceptance. A recently developed transesophageal Doppler device, Accucom 2, features technological advances aimed to reduce the error of this approach to the monitoring of cardiac output. To determine if Accucom 2 enables more accurate cardiac output monitoring, a prospective investigation was undertaken. Analyses of 923 simultaneous measurements of transesophageal Doppler and thermodilution cardiac output in 47 anesthetized patients were compared. Results using Accucom 2 were highly correlated with the results obtained with thermodilution (R = 0.91) and provided significantly greater accuracy in comparison with a previously developed Doppler cardiac output monitor, Accucom 1. Technological advances in transesophageal Doppler ultrasound hold promise for clinically useful noninvasive monitoring of cardiac output.