Study to determine the repeatability of supra-sternal Doppler (ultrasound cardiac output monitor) during general anaesthesia: effects of scan quality,

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Study to determine the repeatability of supra-sternal Doppler (ultrasound cardiac output monitor) during general anaesthesia: effects of scan quality, flow volume, and increasing age L. Huang, L.A.H. Critchley British Journal of Anaesthesia Volume 111, Issue 6, Pages 907-915 (December 2013) DOI: 10.1093/bja/aet254 Copyright © 2013 The Author(s) Terms and Conditions

Fig 1 Typical screen image of a well-focused optimum aortic valve Doppler flow profile held steady for a 7.5 s sweep and saved on the USCOM’s screen. Each flow profile is automatically outlined and Doppler flow variables calculated. Lower windows show four selected variables and a trend plot of previously saved CO readings. The Cattermole score of these flow profiles is 9 of 12.4 British Journal of Anaesthesia 2013 111, 907-915DOI: (10.1093/bja/aet254) Copyright © 2013 The Author(s) Terms and Conditions

Fig 2 Scatter plot comparing the insonation assessment against Cattermole scores. The Cattermole score was based on the average from six readings. British Journal of Anaesthesia 2013 111, 907-915DOI: (10.1093/bja/aet254) Copyright © 2013 The Author(s) Terms and Conditions

Fig 3 Repeatability plots of USCOM flow variables CO, SVI, Vpk, and FTc showing the increases in CV as the Cattermole score worsened (n=173 patients). A high score represented a good-quality signal. Above a CV of 5%, the USCOM scan was considered to lack the discriminative power to show reliable changes in the Doppler flow variable. British Journal of Anaesthesia 2013 111, 907-915DOI: (10.1093/bja/aet254) Copyright © 2013 The Author(s) Terms and Conditions

Fig 4 Box plot showing the decrease in Cattermole score with increasing age. British Journal of Anaesthesia 2013 111, 907-915DOI: (10.1093/bja/aet254) Copyright © 2013 The Author(s) Terms and Conditions

Fig 5 Scatter plot (a) of Cattermole scores against the patient’s age (filled circles) and SVI (open circles). As SVI increases, the Cattermole score improves, whereas the score becomes worse with increasing age. Regression plot (b) shows predicted Cattermole scores from derived age-SVI formula against the patient’s age. British Journal of Anaesthesia 2013 111, 907-915DOI: (10.1093/bja/aet254) Copyright © 2013 The Author(s) Terms and Conditions