Comparison of cardiac output measurement using the CardioQP<sup>TM</sup> oesophageal Doppler with cardiac output measurement using thermodilution technique in children during heart catheterisation*

Knirsch, Walter; Kretschmar, Oliver; Tomaske, Maren; Stutz, K.; Nagdyman, Nicole; Balmer, Christian; Schmitz, A.; Berger, Felix; Bauersfeld, Urs; Weiss, Michel

doi:10.1111/j.1365-2044.2008.05495.x

Cited by 27 publications

(19 citation statements)

References 23 publications

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“…Cross-over designs are also statistically efficient and require fewer subjects than do non-crossover designs (even other repeated measures designs). Secondly, the agreement of the cardiac output measurement between the transoesophageal Doppler probe using CardioQP and the thermodilution technique during heart catheterisation in paediatric patients was described as weak [20]. However the CardioQP seems to be capable of detecting slight changes in cardiac output for critically ill children [21, 22].…”

Section: Discussionmentioning

confidence: 99%

Physiological effects of invasive ventilation with neurally adjusted ventilatory assist (NAVA) in a crossover study

Liet¹,

Barrière²,

Roux³

et al. 2016

BMC Pediatr

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BackgroundNeurally Adjusted Ventilatory Assist (NAVA) is a mode of assisted mechanical ventilation that delivers inspiratory pressure proportionally to the electrical activity of the diaphragm. To date, no pediatric study has focused on the effects of NAVA on hemodynamic parameters. This physiologic study with a randomized cross-over design compared hemodynamic parameters when NAVA or conventional ventilation (CV) was applied.MethodsAfter a baseline period, infants received NAVA and CV in a randomized order during two consecutive 30-min periods. During the last 10 min of each period, respiratory and hemodynamic parameters were collected. No changes in PEEP, FiO2, sedation or inotropic doses were allowed during these two periods. The challenge was to keep minute volumes constant, with no changes in blood CO2 levels and in pH that may affect the results.ResultsSix infants who had undergone cardiac surgery (mean age 7.8 ± 4.1 months) were studied after parental consent. Four of them had low central venous oxygen saturation (ScvO2 < 65 %). The ventilatory settings resulted in similar minute volumes (1.7 ± 0.4 vs. 1.6 ± 0.6 ml/kg, P = 0.67) and in similar tidal volumes respectively with NAVA and with CV. There were no statistically significant differences on blood pH levels between the two modes of ventilation (7.32 ± 0.02 vs. 7.32 ± 0.04, P = 0.34). Ventilation with NAVA delivered lower peak inspiratory pressures than with CV: -32.7 % (95 % CI: -48.2 to –17.1 %, P = 0.04). With regard to hemodynamics, systolic arterial pressures were higher using NAVA: +8.4 % (95 % CI: +3.3 to +13.6 %, P = 0.03). There were no statistically significant differences on cardiac index between the two modes of ventilation. However, all children with a low baseline ScvO2 (<65 %) tended to increase their cardiac index with NAVA compared to CV: 2.03 ± 0.30 vs. 1.91 ± 0.39 L/min.m2 (median ± interquartile, P = 0.07).ConclusionsThis pilot study raises the hypothesis that NAVA could have beneficial effects on hemodynamics in children when compared to a conventional ventilatory mode that delivered identical PEEP and similar minute volumes.Trial registrationClinicalTrials.gov Identifier: NCT01490710. Date of registration: December 7, 2011.

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Section: Discussionmentioning

confidence: 99%

Physiological effects of invasive ventilation with neurally adjusted ventilatory assist (NAVA) in a crossover study

Liet¹,

Barrière²,

Roux³

et al. 2016

BMC Pediatr

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“…A systematic review of the use of various Doppler techniques in children for measuring cardiac output found acceptable reproducibility [16], though a recent study in paediatric patients with congenital heart defects found less good agreement [17].…”

Section: Technique Developmentmentioning

confidence: 99%

Oesophageal Doppler

Singer

2009

Current Opinion in Critical Care

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“…However, descending aorta pulsatility is of concern for accurate cross-section area calculation [36].…”

Section: Doppler Phenomenonmentioning

confidence: 99%

“…TPID techniques to measure global end-diastolic volume have gained popularity in adults, but paediatric studies have demonstrated limited accuracy [36]. Alternative, non-invasive measures of preload assessment have been sought.…”

Section: Preload Assessmentmentioning

confidence: 99%

New Methods of Monitoring Shock in Children

Turnham

Brierley

2015

Curr Treat Options Peds

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Opinion statementShock in children is a cause of significant morbidity and mortality. Worldwide, most children dying from shock do not have the opportunity to benefit from advanced critical care support and we recommend to readers the World Health Organization ETAT guidelines [1]. For children treated in the intensive care environment, standard cardiovascular measures such as heart rate, pulse volume, perfusion/capillary refill, core-peripheral temperature gradient and blood pressure along with measures from other organ systems (e.g. urine output and consciousness level) remain vital. All are part of the global assessment of cardiovascular performance and shock in children, and none of the new techniques we describe replace the need for these assessments in critically ill children. Furthermore, evidence is lacking to mandate utilisation of any of the advanced methods we review and they should only be considered as adjuncts to the aforementioned assessments in critical care. We suggest that the optimal monitoring of the shocked child in the ICU, and those developing shock outside the ICU, should include measuring those hemodynamic parameters above together with assessment of preload responsiveness and organ perfusion. Early goal-directed therapy targeting shock reversal remains the consensus best practice position and includes optimization of several haemodynamic parameters [2]. Our personal practice remains to firstly target clearance of raised lactate and venous desaturation, measured by intermittent blood gas analysis and secondly to optimise preload, contractility and afterload guided by Doppler ultrasound or echocardiography. Both can be undertaken in both the emergency department as well as the ICU.

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Comparison of cardiac output measurement using the CardioQP^TM oesophageal Doppler with cardiac output measurement using thermodilution technique in children during heart catheterisation*

Cited by 27 publications

References 23 publications

Physiological effects of invasive ventilation with neurally adjusted ventilatory assist (NAVA) in a crossover study

Physiological effects of invasive ventilation with neurally adjusted ventilatory assist (NAVA) in a crossover study

Oesophageal Doppler

New Methods of Monitoring Shock in Children

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Comparison of cardiac output measurement using the CardioQPTM oesophageal Doppler with cardiac output measurement using thermodilution technique in children during heart catheterisation*

Cited by 27 publications

References 23 publications

Physiological effects of invasive ventilation with neurally adjusted ventilatory assist (NAVA) in a crossover study

Physiological effects of invasive ventilation with neurally adjusted ventilatory assist (NAVA) in a crossover study

Oesophageal Doppler

New Methods of Monitoring Shock in Children

Contact Info

Product

Resources

About

Comparison of cardiac output measurement using the CardioQP^TM oesophageal Doppler with cardiac output measurement using thermodilution technique in children during heart catheterisation*