Oswin Grollmuss1, Serge Demontoux, André Capderou, Alain Serraf, Emre Belli. 1. Department of Pediatric Cardiac Intensive Care, Centre Chirurgical Marie Lannelongue, INSERM 999, University Paris Sud, 133, Avenue de Résistance, 92350 Le Plessis Robinson, France. osgro@aol.com
Abstract
PURPOSE: Cardiac output (CO), the product of stroke volume (SV) and heart rate, is essential to guarantee organ perfusion, especially in the intensive care setting. As invasive measurement of CO bears the risk of complications there is a need for non-invasive alternatives. We investigated if electrical velocimetry (EV) and transthoracic Doppler (Doppler-TTE) are interchangeable for the non-invasive measurement of SV and able to reflect the post-surgical SV/CO trend. METHODS: Comparison of SV measurements by EV and Doppler-TTE was performed in 24 newborns after switch operation (n = 240 measurements). Three subgroups of measurements (=periods) were created according to the patients' status in the course of post-surgical CO recovery. RESULTS: Bland-Altman analysis found acceptable bias and limits of agreement for the interchangeability of the two methods. Mean overall SV was 3.7 ml with a mean overall bias of 0.28 ml (=7.6 %). The mean percentage error of 29 % was acceptable according to the method of Critchley and Critchley. Overall precision expressed by the coefficient of variation (CV) was 6.6 % for SV(TTE) and 4.4 % for SV(EV). SV(TTE) and SV(EV) medians in the three periods were significantly different and documented the post-surgical CO trend. CONCLUSIONS: EV and Doppler-TTE are interchangeable for estimating SV. EV has the advantages of easy handling and allows continuous measurement.
PURPOSE: Cardiac output (CO), the product of stroke volume (SV) and heart rate, is essential to guarantee organ perfusion, especially in the intensive care setting. As invasive measurement of CO bears the risk of complications there is a need for non-invasive alternatives. We investigated if electrical velocimetry (EV) and transthoracic Doppler (Doppler-TTE) are interchangeable for the non-invasive measurement of SV and able to reflect the post-surgical SV/CO trend. METHODS: Comparison of SV measurements by EV and Doppler-TTE was performed in 24 newborns after switch operation (n = 240 measurements). Three subgroups of measurements (=periods) were created according to the patients' status in the course of post-surgical CO recovery. RESULTS: Bland-Altman analysis found acceptable bias and limits of agreement for the interchangeability of the two methods. Mean overall SV was 3.7 ml with a mean overall bias of 0.28 ml (=7.6 %). The mean percentage error of 29 % was acceptable according to the method of Critchley and Critchley. Overall precision expressed by the coefficient of variation (CV) was 6.6 % for SV(TTE) and 4.4 % for SV(EV). SV(TTE) and SV(EV) medians in the three periods were significantly different and documented the post-surgical CO trend. CONCLUSIONS: EV and Doppler-TTE are interchangeable for estimating SV. EV has the advantages of easy handling and allows continuous measurement.
Authors: C Schmidt; G Theilmeier; H Van Aken; P Korsmeier; S P Wirtz; E Berendes; A Hoffmeier; A Meissner Journal: Br J Anaesth Date: 2005-09-09 Impact factor: 9.166
Authors: Stephan Schubert; Thomas Schmitz; Markus Weiss; Nicole Nagdyman; Michael Huebler; Vladimir Alexi-Meskishvili; Felix Berger; Brigitte Stiller Journal: J Clin Monit Comput Date: 2008-07-30 Impact factor: 2.502
Authors: Frederik Trinkmann; Manuel Berger; Christina Doesch; Theano Papavassiliu; Stefan O Schoenberg; Martin Borggrefe; Jens J Kaden; Joachim Saur Journal: J Clin Monit Comput Date: 2015-06-27 Impact factor: 2.502
Authors: Martin Ernst Blohm; Jana Hartwich; Denise Obrecht; Jan Felix Kersten; Dominique Singer Journal: J Clin Monit Comput Date: 2016-04-12 Impact factor: 2.502