Objective: To investigate the validity of transesophageal echo-Doppler technique for hemodynamic monitoring of patients with extensive burns during shock stage to provide guidance for fluid resuscitation.
Methods: Mongrel dogs were inflicted with 50% TBSA full-thickness burns. Cardiac output (CO) were determined by Swan-Ganz catheter, and other hemodynamic indices by transesophageal echo-Doppler device, including aortic blood flow (ABF), stroke volume (SVa), left ventricle ejection time (LVET), peak velocity (PV), max acceleration (max ACC), total systemic vascular resistance (TSVR) were collected before and after burns. Hemodynamic indices of ten patients with extensive burns were collected by transesophageal echo-Doppler device with in 24 hours after the injury.
Results: Both CO and ABF showed continuous decrease after burns, and there was positive correlation between them (r = 0.90, P < 0.01). The myocardiac contractibility (ACC, PV) and the preload of the left ventricle (LVET) were also decreased continuously after bums,but the postburn afterload (TSVR) were obviously increased. For the patients with conventional therapy, the hemodynamic state of low cardiac output and high peripheral resistance during early period was converted to high cardiac output and low peripheral resistance 24 hours after injury.
Conclusion: Transesophageal echo-Doppler technique is useful in monitoring hemodynamic in patients with extensive burn, and it is non-invasive, real-time, synchronized and rapid, and it can provide complete profile of hemodynamic data.