Non-invasive cardiac output assessment in critically ill paediatric patients

Wongsirimetheekul, Theeranan; Khositseth, Anant; Lertbunrian, Rojjanee

doi:10.1080/ac.69.2.3017298

Cited by 15 publications

(21 citation statements)

References 0 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…While the USCOM has been validated in many settings,21–23 some studies have questioned the accuracy of the device compared with echocardiography and pulmonary artery catheterisation 24 32 33. However, since the goal of our study was to seek differences in cardiac parameters between groups, the absolute accuracy of the measurements should not affect the validity of our findings.…”

Section: Discussionmentioning

confidence: 94%

The effects of malnutrition on cardiac function in African children

et al. 2015

View full text Add to dashboard Cite

The Effects of Malnutrition on Cardiac Function in African ChildrenJonathan A. Silverman Chair of the Supervisory Committee: Associate Professor Stephen Hawes Department of Epidemiology Objective:To assess the effect of malnutrition on cardiac function in hospitalized African children. Design:Prospective cross-sectional study. Setting:Public referral hospital in Blantyre, Malawi. Patients:We enrolled 272 stable, hospitalized children ages 6-59 months, with and without WHO-defined severe acute malnutrition. Main outcome measures:Cardiac index, heart rate, mean arterial pressure, stroke volume index, and systemic vascular resistance index were measured by the Ultrasound Cardiac Output Monitor (USCOM, Ltd, NSW, Australia). We used linear regression with generalized estimating equations controlling for age, sex, and anemia. Results:Our primary outcome, cardiac index, was similar between those with and without severe Conclusions:In this largest study to date of cardiac function in malnourished children we found that that cardiac function is preserved in stable, hospitalized subjects. Lower mean arterial pressure and systemic vascular resistance index may indicate that these children are in a hypermetabolic state due to early effects of refeeding. Further study is needed to determine if cardiac function is diminished in unstable malnourished children. ! 5!Background:

show abstract

Section: Discussionmentioning

confidence: 94%

The effects of malnutrition on cardiac function in African children

et al. 2015

View full text Add to dashboard Cite

show abstract

“…Numerous alternative approaches exist (SVR, SVR index, SV variation, global end-diastolic volume), but to date, only measurement of CO and venous oximetry have been adequately validated and incorporated in clinical guidelines. [68][69][70][71][72][73][74][75][76] Therapeutic interventions of hemodynamic support should be directed at maintaining mixed venous oxygen saturation at !70%, cardiac index between 3.3 and 6 L/minute/m 2 , and a normal perfusion pressure for age. 16,57…”

Section: Management Of Sepsis In Childrenmentioning

confidence: 99%

Pediatric Sepsis: Clinical Considerations

Balázs

Szima²,

Elek

et al. 2017

JCS

View full text Add to dashboard Cite

Sepsis remains one of the leading causes of childhood mortality today, although survival has substantially improved, thanks to an ever deeper and more thorough understanding of sepsis pathophysiology, developments in vaccination and intensive therapy, and goal-directed therapeutic approaches. The key to successful therapy is early recognition and antibiotic treatment, as well as supportive therapy aimed at correcting circulatory, respiratory, and metabolic derangements as soon as possible. Diagnosis and management of childhood sepsis mainly evolves along the path of studies conducted in adult patients; however, their applicability is limited due to a variability of cardiovascular and immune responses in each age group. In addition to childhood characteristics of hemodynamic responses in sepsis, this review looks at major areas of pediatric sepsis therapy, with the intention of providing bedside clinicians with pointers useful in their day-to-day work.

show abstract

“…Measurement of cardiac output is crucial and provides important information in assessment of hemodynamics in critically ill patients [ 1 – 5 ]. In the past, assessment was done invasively using pulmonary artery catheter (PAC) with thermodilution technique and has served as reference standard over the years [ 3 – 9 ]. Nevertheless, the technique is difficult and rarely feasible in children due to limited catheter size and small vessel.…”

Section: Introductionmentioning

confidence: 99%

“…Furthermore, it posed possible complications such as infection and thromboembolic events even in adult studies [ 6 , 10 – 14 ]. Therefore, Doppler studies such as transthoracic echocardiography (TTE) or transesophageal echocardiography (TEE) has been widely used for hemodynamic measurements and has been validated to be equivocal with PAC thermodilution with acceptable validity [ 3 , 13 – 18 ]. Consequently, TTE has replaced PAC with thermodilution in clinical settings.…”

Section: Introductionmentioning

confidence: 99%

“…There are recent developments of noninvasive cardiac output monitoring, such as ultrasonic cardiac output monitor (USCOM) and impedance cardiography (electrical velocimetry; EV) which can be done rapidly in the critical setting and requiring less expertise. USCOM uses Doppler ultrasound to measure the velocity of blood passing through the aortic or pulmonary valve in order to calculate the cardiac output [ 3 – 5 , 19 – 23 ]. EV transcutaneously detects changes in impedance with changes in erythrocyte orientation and flow peak velocity in the ascending aorta for the continuous quantification of cardiac output [ 19 – 21 , 24 – 25 ].…”

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Comparison of three non-invasive hemodynamic monitoring methods in critically ill children

et al. 2018

Self Cite

View full text Add to dashboard Cite

IntroductionHemodynamic parameters measurements were widely conducted using pulmonary artery catheter (PAC) with thermodilution as a reference standard. Due to its technical difficulties in children, transthoracic echocardiography (TTE) has been widely employed instead. Nonetheless, TTE requires expertise and is time-consuming. Noninvasive cardiac output monitoring such as ultrasonic cardiac output monitor (USCOM) and electrical velocimetry (EV) can be performed rapidly with less expertise requirement. Presently, there are inconsistent evidences, variable precision, and reproducibility of EV, USCOM and TTE measurements. Our objective was to compare USCOM, EV and TTE in hemodynamic measurements in critically ill children.Materials and methodsThis was a single center, prospective observational study in critically ill children. Children with congenital heart diseases and unstable hemodynamics were excluded. Simultaneous measurements of hemodynamic parameters were conducted using USCOM, EV, and TTE. Inter-rater reliability was determined. Bland-Altman plots were used to analyse agreement of assessed parameters.ResultsAnalysis was performed in 121 patients with mean age of 4.9 years old and 56.2% of male population. Interrater reliability showed acceptable agreement in all measured parameters (stroke volume (SV), cardiac output (CO), velocity time integral (VTI), inotropy (INO), flow time corrected (FTC), aortic valve diameter (AV), systemic vascular resistance (SVR), and stroke volume variation (SVV); (Cronbach’s alpha 0.76–0.98). Percentages of error in all parameters were acceptable by Bland-Altman analysis (9.2–28.8%) except SVR (30.8%) and SVV (257.1%).ConclusionThree noninvasive methods might be used interchangeably in pediatric critical care settings with stable hemodynamics. Interpretation of SVV and SVR measurements must be done with prudence.

show abstract

Non-invasive cardiac output assessment in critically ill paediatric patients

Abstract: USCOM was an unreliable tool for absolute value measurement of CO and CI due to the errors of VTI by CW Doppler.

Cited by 15 publications

References 0 publications

The effects of malnutrition on cardiac function in African children

The effects of malnutrition on cardiac function in African children

Pediatric Sepsis: Clinical Considerations

Comparison of three non-invasive hemodynamic monitoring methods in critically ill children

Contact Info

Product

Resources

About