Transtracheal Doppler: a new procedure for continuous cardiac output measurement

An endotracheal tube with a 5 mm diameter ultrasonic transducer incorporated into its distal end was inserted into the tracheas of six anesthetized dogs. The device provides for ultrasound measurement of aortic diameter and blood velocity in the ascending aorta to obtain cardiac outputs. Because measurements are made proximal to the origins of the aortic arch vessels, total cardiac output is obtained. Procedures for measurement of aortic diameter, aortic blood velocity, and cardiac output are discussed. The resulting data were used to empirically determine the angle of incidence of the ultrasound beam that gave the best least squares fit over a range of thermodilution cardiac outputs. For an angle of incidence of 62.3 degrees, the relationship between cardiac output determined by thermal dilution and by transtracheal Doppler was transtracheal Doppler cardiac output = -.69 + 1.19 thermal dilution cardiac output. R2 = .82. The results from this preliminary assessment of the feasibility of measuring cardiac output in dogs using transtracheal Doppler suggest that additional studies should be pursued. Additional issues that require investigation include confirmation of constancy of human anatomy and demonstration of lack of tracheal trauma from the Doppler equipped endotracheal tube.