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 with the esophageal Doppler monitor against those obtained with a pulmonary artery 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 esophageal Doppler monitor inserted. Hemodynamic data were recorded on 2 occasions separated by several hours with both the pulmonary artery flotation catheter and the esophageal Doppler monitor simultaneously. Results: The esophageal Doppler monitor underestimated cardiac output by 36% ± 14% (mean ± SD). The esophageal Doppler monitor accurately estimated cardiac output in 3 women >40 years old, whereas in the remaining women (all <35 years old) the esophageal Doppler monitor underestimated cardiac output by 38% ± 11%. The esophageal Doppler monitor accurately reflected changes in cardiac output with time when compared with the pulmonary artery flotation catheter. Conclusion: In women with preeclampsia the esophageal Doppler monitor consistently underestimated cardiac output by approximately 40%. It is not known whether the apparent increase in accuracy among the women >40 years old arose by chance or reflected a real improvement in performance. The esophageal Doppler monitor accurately reflected the direction and magnitude of the changes in cardiac output with time. (Am J Obstet Gynecol 2000;183:658-61.)