Developing a Checklist: Consensus Via a Modified Delphi Technique.

Objective: To create a universal checklist of key preparatory steps to aid anesthesiologists in patient separation from cardiopulmonary bypass.

Design: Multistep, iterative survey with statistically guided refinement of survey items using a modified Delphi technique.

Setting: Internet-based surveys.

Checklist usage decreases critical task omissions when training residents to separate from simulated cardiopulmonary bypass.

Objective: Separation from cardiopulmonary bypass (CPB) requires multiple preparatory steps, during which mistakes, omissions, and human errors may occur. Checklists have been used extensively in aviation to improve performance of complex, multistep tasks. The aim of this study was to (1) develop a checklist using a modified Delphi process to identify essential steps necessary to prepare for separation from CPB, and (2) compare the frequency of completed items with and without the use of a checklist in simulation.

Effect of increasing heart rate and tidal volume on stroke volume variability in vascular surgery patients.

Objective: Because heart rate affects ventricular filling, the aim of the present study was to assess the effects of increasing heart rate and tidal volume on stroke volume variability to determine whether this dynamic index is heart-rate dependent.

Design: Prospective, randomized study.

Setting: Single university hospital.

Accuracy of noninvasive estimated continuous cardiac output (esCCO) compared to thermodilution cardiac output: a pilot study in cardiac patients.

Objective: To compare the noninvasive estimated continuous cardiac output (esCCO), device-derived cardiac output (CO) to simultaneous pulmonary artery catheter (PAC) thermodilution (TD) CO.

Design: A prospective study comparing pulse wave transit time (estimated continuous cardiac output, esCCO; Nihon Kohden, Tokyo, Japan) to intermittent TD CO.

Setting: One academic hospital.

The pocket echocardiograph: a pilot study of its validation and feasibility in intubated patients.

Background: The clinical use of miniaturized echocardiograph devices is expanding due to the potential to rapidly assess cardiac function in the critically ill patient. Novice echocardiographers have used the pocket echocardiograph (PE) to estimate ejection fraction in ambulatory patients, but have not evaluated intubated patients. We hypothesize that a novice echocardiographer can use PE to acquire interpretable cardiac images, and provide an accurate tool for estimating ejection fraction.

Comparison of the endotracheal cardiac output monitor to thermodilution in cardiac surgery patients.

Objectives: To compare cardiac output (CO) measurements from a novel endotracheal bioimpedance cardiac output monitor device (ECOM; ConMed, Irvine, CA) to simultaneous pulmonary artery thermodilution (TD) CO.

Design: Prospective study.

Setting: One academic hospital.

Validation and feasibility of intraoperative three-dimensional transesophageal echocardiographic cardiac output.

Background: In this pilot study, we attempted to validate three-dimensional transesophageal echocardiography (3DTEE) cardiac output and assess its feasibility intraoperatively.

Methods: Twenty patients undergoing cardiac surgery underwent simultaneous cardiac output determinations during the clinically stable prebypass period by 3DTEE and thermodilution.

Results: The correlation coefficient between cardiac output measured by the two methods was 0.