Electrical velocimetry as a tool for measuring cardiac output in small infants after heart surgery

Grollmuss, Oswin; Demontoux, Serge; Capderou, André; Sérraf, Alain; Belli, Emrè

doi:10.1007/s00134-012-2530-3

Cited by 54 publications

(55 citation statements)

References 26 publications

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“…An impedance change occurs between diastole and systole as red blood cell orientation is altered from random during diastole to aligned during systole. [1][2][3][4][5][6][7] This device is validated against Fick cardiac output and transthoracic echocardiography in infants and children, 1,2 as well as thermodilation in adults 7 with R values of 0.9. This device is approved by the Food and Drug Administration (FDA) for use in neonates.…”

Section: Methodsmentioning

confidence: 99%

The Use of Epinephrine in Caudal Anesthesia Increases Stroke Volume and Cardiac Output in Children

Liu

Sui

Coté

et al. 2016

Regional Anesthesia and Pain Medicine

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Section: Methodsmentioning

confidence: 99%

The Use of Epinephrine in Caudal Anesthesia Increases Stroke Volume and Cardiac Output in Children

Liu

Sui

Coté

et al. 2016

Regional Anesthesia and Pain Medicine

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“…The issue of influencing factors or sources of error using EV has been addressed in some adult [30,40] and pediatric studies [8,35,36]. Further, some adult [42] and pediatric studies have assessed the trending ability of the EV method [8][9][10][11][12].…”

Section: Introductionmentioning

confidence: 97%

“…Most previous validation studies on EV (and other impedance cardiography devices) compared with different invasive and non-invasive CO monitoring methods have focused on equivalence between methods. These equivalence studies found conflicting data depending on the studied patient group, with better equivalence in more homogeneous or anesthetized patient cohorts [8,10,30,[32][33][34][35] and nonequivalence in inhomogeneous patient groups, with e.g., different cardiac anatomy [36][37][38] or inhomogeneous body fluid composition [39], and an influence of sex, height, increasing CO, and stroke volume [40]. A methodical issue in any CO monitoring method comparison involves the duration of sampling interval time, with better equivalence in validation studies using longer sampling intervals (i.e., more heart cycles) compared to studies using short sampling intervals [41].…”

Section: Introductionmentioning

confidence: 98%

“…Nevertheless, in validation studies the novel method is usually compared with a reference method [1][2][3][4][5][6][7]. 'Reproducibility' and 'trending ability' are of interest [5][6][7][8][9][10][11][12]. Likewise reproducibility is an important factor for trending ability, yet a method might be reproducible but unable to track changes correctly.…”

Section: Introductionmentioning

confidence: 99%

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Effect of patent ductus arteriosus and patent foramen ovale on left ventricular stroke volume measurement by electrical velocimetry in comparison to transthoracic echocardiography in neonates

Blohm

Hartwich

Obrecht

et al. 2016

J Clin Monit Comput

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This prospective single-center observational study compared impedance cardiography [electrical velocimetry (EV)] with transthoracic echocardiography (TTE, based on trans-aortic flow) and analyzed the influence of physiological shunts, such as patent ductus arteriosus (PDA) or patent foramen ovale (PFO), on measurement accuracy. Two hundred and ninety-one triplicate simultaneous paired left ventricular stroke volume (LVSV) measurements by EV (LVSV) and TTE (LVSV) in 99 spontaneously breathing neonates (mean weight 3270 g; range 1227-4600 g) were included. For the whole cohort, the mean absolute LVSV was 5.5 mL, mean LVSV was 4.9 mL, resulting in an absolute Bland-Altman bias of -0.7 mL (limits of agreement LOA -3.0 to 1.7 mL), relative bias -12.8 %; mean percentage error MPE 44.9 %; true precision TP 33.4 % (n = 99 aggregated data points). In neonates without shunts (n = 32): mean LVSV 5.0 mL, mean LVSV 4.6 mL, Bland-Altman bias -0.4 mL (LOA -2.8 to 2.0 mL), relative bias -8.2 %; MPE 50.7 %; TP 40.9 %. In neonates with shunts (PDA and/or PFO; n = 67): mean LVSV 5.8 mL, mean LVSV 5.0 mL, bias -0.8 mL (LOA -3.1 to 1.5 mL), relative bias -14.8 %, MPE 41.9 %, TP 29.3 %. Accuracy was affected by PDA and/or PFO, with a significant increase in the relative difference in LVSV versus LVSV: Subjects without shunts -2.9 % (n = 91), PFO alone -9.6 % (n = 125), PDA alone -14.0 % (n = 12), and PDA and PFO -18.5 % (n = 63). Physiological shunts (PDA and/or PFO) in neonates affect measurement accuracy and cause overestimation of LVSV compared with LVSV.

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“…By using transthoracic Echo, the accuracy of EC in term [6,7] and even preterm neonates [8,9,10,11] has been described. It has been studied in different clinical scenarios including surgical ligation for patent ductus arteriosus (PDA) [12], hemodynamic transition after birth [13], caffeine administration [14], and umbilical cord milking in preterm infants [15].…”

Section: Introductionmentioning

confidence: 99%

Electrical Cardiometry to Monitor Cardiac Output in Preterm Infants with Patent Ductus Arteriosus: A Comparison with Echocardiography

Hsu¹,

et al. 2017

Neonatology

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Background: Electrical cardiometry (EC) is an impedance-based monitoring that provides noninvasive cardiac output (CO) assessment. Through comparison to transthoracic echocardiography (Echo), the accuracy of EC has been verified. However, left-to-right patent ductus arteriosus (PDA) shunting is a concern because PDA shunts aortic flow to the pulmonary artery and may interfere with EC in measuring CO. Objective: To determine the agreement between EC and Echo in preterm infants with a hemodynamically significant PDA (hsPDA). Methods: We reviewed our hemodynamic database in which simultaneous CO measurements by Echo and EC (Aesculon®) were recorded. Preterm infants with left-to-right shunting hsPDA were enrolled. Results: A total of 105 paired measurements in 36 preterm infants were compared. Infants' median (range) age and weight at measurement were 27⁺² weeks (24⁺⁰-33⁺¹) and 1,015 g (518-1,880), with mean (95% CI) ductal diameter 2.11 mm (1.99-2.22) or 2.15 mm/kg (2.00-2.30). Mean CO_EC and CO_Echo were 252 ± 32 and 258 ± 45 mL/kg/min, respectively, which demonstrated a moderate correlation and without a significant between-measurement difference. Bland-Altman analysis showed a bias, limits of agreement, and error percentage of -5.3 mL/kg/min, -78.3 to 67.7 mL/kg/min, and 28.6%, respectively. There was a trend of increased bias and error percentage of infants with high CO ≥280 mL/kg/min and supported with high-frequency ventilator. Conclusions: EC and Echo have a wide but clinically acceptable agreement in measuring CO in preterm infants with hsPDA. However, for infants with high CO or ventilated by high-frequency ventilation, interpretation of CO_EC should be approached with caution.

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Electrical velocimetry as a tool for measuring cardiac output in small infants after heart surgery

Abstract: EV and Doppler-TTE are interchangeable for estimating SV. EV has the advantages of easy handling and allows continuous measurement.

Cited by 54 publications

References 26 publications

The Use of Epinephrine in Caudal Anesthesia Increases Stroke Volume and Cardiac Output in Children

The Use of Epinephrine in Caudal Anesthesia Increases Stroke Volume and Cardiac Output in Children

Effect of patent ductus arteriosus and patent foramen ovale on left ventricular stroke volume measurement by electrical velocimetry in comparison to transthoracic echocardiography in neonates

Electrical Cardiometry to Monitor Cardiac Output in Preterm Infants with Patent Ductus Arteriosus: A Comparison with Echocardiography

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