Cardiac output measurement with transpulmonary ultrasound dilution is feasible in the presence of a left-to-right shunt: a validation study in lambs

Abstract

TPUD is a reliable technology to measure CO in the presence of a left-to-right shunt.

Accuracy of the transpulmonary ultrasound dilution method for detection of small anatomic shunts

“…Transpulmonary ultrasound dilution (UD) (COstatus Ò Transonic systems, Ithaca, NY, USA) is a novel, invasive technology [6] capable of accurately measuring cardiac output and blood volumes in small children [7], pediatric animal models [8,9] and adults [10,11]. In addition to hemodynamic volumetric assessment, UD technology can detect the presence of anatomical shunts based upon the shape of the dilution curves.…”

Determination of cardiac output by ultrasound dilution technique in infants and children: a validation study against direct Fick principle

“…33 Additionally, UDT provides the opportunity to identify shunts, quantify their magnitude, and measure CO in the presence of left-to-right shunts. 34 Analysis of the dilution curve also offers the opportunity to assess volumetric parameters such as central blood volume (CBV) (total blood volume of the thorax), total enddiastolic volume (TEDV) (sum of all end-diastolic volumes of the atria and ventricles), and active circulating volume (ACV) (blood volume in which isotonic saline mixes within 1 min). 9 There is growing evidence from clinical studies in children that CBV and TEDV might be more indicative for cardiac preload and intravascular volume status than cardiac filling strains such as central venous or pulmonary capillary wedge pressure 35 and that ACVas a potential indicator of cardiac afterload strongly correlates with systemic vascular resistance.…”

Validation of an Ultrasound Dilution Technology for Cardiac Output Measurement and Shunt Detection in Infants and Children

“…In another study (25), the same group instrumented lambs with an artificial left-to-right shunt between the distal aorta and the left PA branch. The mean CO values (1.53-1.65 L/min) were a little higher than in our study (0.83-1.29 L/min), but the overall PE of 19.1% was practically the same as ours.…”