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Oesophageal Doppler guided optimization of cardiac output does not increase visceral microvascular blood flow in healthy volunteers

Heinink, Thomas P.; Read, David J.; Mitchell, William K.; Bhalla, Ashish; Lund, Jonathan N.; Phillips, Bethan E.; Williams, John P.

Authors

Thomas P. Heinink

David J. Read

William K. Mitchell

Ashish Bhalla

Jonathan N. Lund

Bethan E. Phillips

John P. Williams



Abstract

Background

Oesophageal Doppler monitoring (ODM) is used clinically to optimize cardiac output (CO) and guide fluid therapy. Despite limited experimental evidence, it is assumed that increasing CO increases visceral microvascular blood flow (MBF). We used contrast-enhanced ultrasound (CEUS) to assess whether ODM-guided optimization of CO altered MBF.
Methods

Sixteen healthy male volunteers (62 ± 3·4 years) were studied. Baseline measurements of CO were recorded via ODM. Hepatic and renal MBF was assessed via CEUS. Saline 0·9% was administered to optimize CO according to a standard protocol and repeat CEUS performed. Time–intensity curves were constructed, allowing organ perfusion calculation via time to 5% perfusion (TT5). MBF was assessed via organ perfusion rise time (RT) (5–95%).
Results

CO increased (4535 ± 241 ml/min versus 5442 ± 329 ml/min, P

Journal Article Type Article
Journal Clinical Physiology and Functional Imaging
Print ISSN 1475-0961
Electronic ISSN 1475-097X
Publisher Wiley
Peer Reviewed Peer Reviewed
APA6 Citation Heinink, T. P., Read, D. J., Mitchell, W. K., Bhalla, A., Lund, J. N., Phillips, B. E., & Williams, J. P. (in press). Oesophageal Doppler guided optimization of cardiac output does not increase visceral microvascular blood flow in healthy volunteers. Clinical Physiology and Functional Imaging, doi:10.1111/cpf.12401
DOI https://doi.org/10.1111/cpf.12401
Keywords cardiac output; CEUS ; contrast-enhanced Ultrasound; healthy volunteers; oesophageal Doppler
Publisher URL http://onlinelibrary.wiley.com/doi/10.1111/cpf.12401/abstract
Copyright Statement Copyright information regarding this work can be found at the following address: http://eprints.nottingh.../end_user_agreement.pdf
Additional Information This is the peer reviewed version of the following article: Heinink, T. P., Read, D. J., Mitchell, W. K., Bhalla, A., Lund, J. N., Phillips, B. E. and Williams, J. P. (2017), Oesophageal Doppler guided optimization of cardiac output does not increase visceral microvascular blood flow in healthy volunteers. Clin Physiol Funct Imaging, which has been published in final form at http://dx.doi.org/10.1111/cpf.12401. This article may be used for non-commercial purposes in accordance with Wiley Terms and Conditions for Self-Archiving.

Files

Submitted manuscript to functional imaging July 2016.pdf (923 Kb)
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Copyright Statement
Copyright information regarding this work can be found at the following address: http://eprints.nottingham.ac.uk/end_user_agreement.pdf





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