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Impedance cardiography (electrical velocimetry) and transthoracic echocardiography for non-invasive cardiac output monitoring in pediatric intensive care patients: a prospective single-center observational study.
Blohm, Martin Ernst; Obrecht, Denise; Hartwich, Jana; Mueller, Goetz Christoph; Kersten, Jan Felix; Weil, Jochen; Singer, Dominique.
Afiliação
  • Blohm ME; Department of Pediatrics, Division of Neonatology and Pediatric Intensive Care, University Medical Center Hamburg-Eppendorf, Martinistr. 52, Hamburg, 20246, Germany. m.blohm@uke.de.
  • Obrecht D; Department of Pediatrics, Division of Neonatology and Pediatric Intensive Care, University Medical Center Hamburg-Eppendorf, Martinistr. 52, Hamburg, 20246, Germany. denise.obrecht@gmx.de.
  • Hartwich J; Department of Pediatrics, Division of Neonatology and Pediatric Intensive Care, University Medical Center Hamburg-Eppendorf, Martinistr. 52, Hamburg, 20246, Germany. jana.hartwich@gmx.de.
  • Mueller GC; Current address: Department of Neurology, Elbe Kliniken Stade, Bremervörder Str. 111, Stade, 21682, Germany. jana.hartwich@gmx.de.
  • Kersten JF; Department of Pediatric Cardiology, University Medical Center Hamburg-Eppendorf, Martinistr. 52, Hamburg, 20246, Germany. go.mueller@uke.de.
  • Weil J; Department of Medical Biometry and Epidemiology, University Medical Center Hamburg-Eppendorf, Martinistr. 52, Hamburg, 20246, Germany. j.kersten@uke.de.
  • Singer D; Department of Pediatric Cardiology, University Medical Center Hamburg-Eppendorf, Martinistr. 52, Hamburg, 20246, Germany. j.weil@uke.de.
Crit Care ; 18(6): 603, 2014 Nov 19.
Article em En | MEDLINE | ID: mdl-25407329
ABSTRACT

INTRODUCTION:

Electrical velocimetry (EV) is a type of impedance cardiography, and is a non-invasive and continuously applicable method of cardiac output monitoring. Transthoracic echocardiography (TTE) is non-invasive but discontinuous.

METHODS:

We compared EV with TTE in pediatric intensive care patients in a prospective single-center observational study. Simultaneous, coupled, left ventricular stroke volume measurements were performed by EV using an Aesculon® monitor and TTE (either via trans-aortic valve flow velocity time integral [EVVTI], or via M-mode [EVMM]). H0 bias was less than 10% and the mean percentage error (MPE) was less than 30% in Bland-Altman analysis between EV and TTE. If appropriate, data were logarithmically transformed prior to Bland-Altman analysis.

RESULTS:

A total of 72 patients (age 2 days to 17 years; weight 0.8 to 86 kg) were analyzed. Patients were divided into subgroups organ transplantation (OTX, n = 28), sepsis or organ failure (SEPSIS, n = 16), neurological patients (NEURO, n = 9), and preterm infants (PREM, n = 26); Bias/MPE for EVVTI was 7.81%/26.16%. In the EVVTI subgroup analysis for OTX, NEURO, and SEPSIS, bias and MPE were within the limits of H0, whereas the PREM subgroup had a bias/MPE of 39.00%/46.27%. Bias/MPE for EVMM was 8.07%/37.26% where the OTX and NEURO subgroups were within the range of H0, but the PREM and SEPSIS subgroups were outside the range. Mechanical ventilation, non-invasive continuous positive airway pressure ventilation, body weight, and secondary abdominal closure were factors that significantly affected comparison of the methods.

CONCLUSIONS:

This study shows that EV is comparable with aortic flow-based TTE for pediatric patients.
Assuntos

Texto completo: 1 Base de dados: MEDLINE Assunto principal: Reologia / Ecocardiografia / Débito Cardíaco / Unidades de Terapia Intensiva Pediátrica / Monitorização Fisiológica Idioma: En Ano de publicação: 2014 Tipo de documento: Article

Texto completo: 1 Base de dados: MEDLINE Assunto principal: Reologia / Ecocardiografia / Débito Cardíaco / Unidades de Terapia Intensiva Pediátrica / Monitorização Fisiológica Idioma: En Ano de publicação: 2014 Tipo de documento: Article