Clinical & cost effectiveness of oesophageal Doppler monitoring

What is the clinical and cost effectiveness of oesophageal Doppler monitoring in critically ill and high risk surgical patients?

Investigators

Vale, L. (HERU/HSRU) Mowatt, G., Grant, A., Fraser, C., Cuthbertson, B. Sunnybrook Health Science Centre, Toronto) Hernández, R. (HERU) and Houston, G. (Department of Anaesthetics, Aberdeen Royal Infirmary)

Summary

It is believed that measuring heart function during critical illness or during surgery can improve patient outcomes. Until recently the main method used to measure heart function has been pulmonary artery catheterisation (PAC), although for people undergoing surgery even this approach is uncommon. Whilst providing useful information, PACs have not been shown to improve mortality.

This review assessed the effectiveness and cost-effectiveness of oesophageal Doppler monitoring (ODM) when used for monitoring heart function in comparison with (i) standard care (i.e. no cardiac output monitor perioperatively amongst patients undergoing major surgery; and (ii) other methods of monitoring heart function such as pulmonary artery catheterisation or pulse contour monitoring devices in critically ill patients or in patients undergoing major surgery.

Contact

R Hernández

Status

Complete

Publications

Mowatt, G., Houston, G., Hernández, R., de Verteuil, R., Fraser, C., Cuthbertson, B. and Vale, L. Systematic review of the clinical effectiveness and cost-effectiveness of oesophageal Doppler monitoring in critically ill and high risk surgical patients. Health Technology Assessment. 2009; 13(7).

Mowatt, G., Houston, G., Hernández, R., de Verteuil, R., Fraser, C., Cuthburtson, B. and Vale, L. Evidence review: Oesophageal Doppler monitoring in patients undergoing high-risk surgery and in critically ill patients. Report to the NHS Centre for Evidence Based Purchasing. April 2008.

Presentations

Maeso-Martínez, S., Callejo, D., Gracia, D., Hernández, R., Blasco, J.A. and Andradas, E. Cost-effectiveness of oesophageal Doppler haemodynamic monitoring during colorectal resection surgery. Health Technology Assessment International Society. Montreal, Canada. July 2008.

Callejo, D., Maeso, S., Gracia, J., Escalona, S., Blasco, J.A. and Hernández, R. Efficiency of Oesophageal Doppler Monitoring system during hip fracture repairing surgery. HTAi. Montreal, July 2008.

Hernández, R., de Verteuil, R. and Vale, L. for the Aberdeen ODM TAR Group, Oesophageal Doppler monitoring in critically ill and high risk surgical patients: a first step towards efficiency. HTAi. Montreal, July 2008.

Maeso-Martinez, S., Callejo, D., Gracia, C., Hernández, R., Blasco., J.A. and Andradas, E. Cost-effectiveness of oesophageal Doppler haemodynamic monitoring during colorectal resection surgery. XVIII Jornadas de Economia de la Salud. Salamanca, May 2008.