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CARDIAC OUTPUT MEASUREMENT IN THE CHILDREN AFTER CARDIAC SURGERY: COMPARISON OF ULTRASOUND MONITORING OF CARDIAC OUTPUT AND ECHOCARDIOGRAPHY

https://doi.org/10.21292/2078-5658-2018-15-4-42-47

Abstract

The objective: to assess the accuracy of cardiac output measurement by ultrasonic cardiac output monitor (USCOM) versus echocardiography (ECHO) in the children after cardiac surgery.

Subjects and methods: A prospective observational trial was conducted (288 patients were assessed for eligibility, and data from 88 patients were analyzed). Cardiac output was measured by USCOM and ECHO.

Results. The age of the patients was 305 ± 177 days. Cardiac output measured by USCOM, was 1.310 ± 0.605 [1.182; 1.438] L/min, while the one measured by ECHO made 1.298 ± 0.608 [1.169; 1.427] L/min. ANOVA demonstrated no statistically significant difference (p = 0.89). A significant positive correlation was found between cardiac output rates measured by two methods (r = 0.945 [0.918, 0.964], p < 0.0001). The Bland-Altman plot demonstrated the shift of 0.012 ± 0.200 L/min. and agreement limits from -0.38 to 0.4 L/min. There was no correlation between the shift and median values of cardiac output (r = -0.015 [-0.224, 0.195], p = 0.89).

Conclusions. USCOM credibly measures the cardiac output versus the reference method of ECHO. Despite the known limitations, both methods can be used in children after cardiac surgery: USCOM − for screening, ECHO ‒ for deeper examination.

About the Authors

N. P. Leonov
E.N. Meshalkin Research Institute of Blood Circulation Pathology.
Russian Federation

Nikolay P. Leonov Candidate of Medical Sciences, Anesthesiologist and Emergency Physician of Anesthesiology and Intensive Care Unit, Junior Researcher of Anesthesiology and Intensive Care Center.

15, Rechkunovskaya St., Novosibirsk, 630055.



O. V. Strunin
E.N. Meshalkin Research Institute of Blood Circulation Pathology.
Russian Federation

Oleg V. Strunin Doctor of Medical Sciences, Head of Anesthesiology and Intensive Care Unit.

15, Rechkunovskaya St., Novosibirsk, 630055.



O. V. Poletaeva
E.N. Meshalkin Research Institute of Blood Circulation Pathology.
Russian Federation

Natalya V. Poletaeva Anesthesiologist and Emergency Physician of Anesthesiology and Intensive Care Unit. 

15, Rechkunovskaya St., Novosibirsk, 630055.



V. V. Lomivorotov
E.N. Meshalkin Research Institute of Blood Circulation Pathology.
Russian Federation

Vladimir V. Lomivorotov Correspondent Member of RAS, Doctor of Medical Sciences, Professor, Deputy Director for Research, Head of Anesthesiology and Intensive Care Center.

15, Rechkunovskaya St., Novosibirsk, 630055.



A. M. Karaskov
E.N. Meshalkin Research Institute of Blood Circulation Pathology.
Russian Federation

Aleksandr M. Karaskov Academician of RAS, Doctor of Medical Sciences, Professor, Director. 

15, Rechkunovskaya St., Novosibirsk, 630055.



References

1. Kuzkov V.V., Kirov M.Yu. Invasivny monitoring hemodinamiki v intensivnoy treapii i anesteziologii. [Invasive monitoring of hemodynamics in intensive therapy and anesthesiology]. 2nd Edition, reviewed and supplemented, Arkhangelsk, Northern State Medical University Publ., 2015, 392 p.

2. Lekmanov А.U., Аzovskiy D.K., Pilyutik S.F. Comparison of Doppler ultrasonography and transpulmonary thermodilution when analyzing hemodynamic rates in the children with severe thermal injury. Vestn. Anesteziologii I Reanimatologii, 2017, 14, no. 1, pp. 42-50. (In Russ.)

3. Paromov K.V., Lenkin А.I., Kuzkov V.V. et al. Targeted optimization of hemodynamics in the peri-operative period: opportunities and perspectives. Patologiya Krovoobrascheniya i Kardiokhirurgiya, 2014, no. 3, pp. 59-66. (In Russ.)

4. Armstrong W.F., Ryan T. Feigenbaum's Echocardiography, 7th ed. Philadelphia, PA, Lippincott Williams & Wilkins, 2010, 816 p.

5. Bernard S. The patient with shock: is there any role for the non-invasive monitoring of cardiac output? Emerg. Med. Australas, 2005, vol. 17, no. 3, pp. 189-190.

6. Brienza N., Giglio M.T., Marucci M. et al. Does perioperative hemodynamic optimization protect renal function in surgical patients? A meta-analytic study. Crit. Care Med., 2009, vol. 37, no. 6, pp. 2079-2090.

7. Cattermole G.N., Leung P.Y., Ho G.Y. et al. The normal ranges of cardiovascular parameters measured using the Ultrasonic Cardiac Output Monitor. Physiol. Rep., 2017, vol. 5, no. 6, pp. e13195.

8. Chong S.W., Peyton P.J. A meta-analysis of the accuracy and precision of the ultrasonic cardiac output monitor (USCOM). Anaesthesia, 2012, vol. 67, no. 11, pp. 1266-1271.

9. Critchley L.A., Lee A., Ho A.M. A critical review of the ability of continuous cardiac output monitors to measure trends in cardiac output. Anesth. Analg., 2010, vol. 111, no. 5, pp. 1180-1192.

10. Donati A., Loggi S., Preiser J.C. et al. Goal-directed intraoperative therapy reduces morbidity and length of hospital stay in high-risk surgical patients. Chest, 2007, vol. 132, no. 6, pp. 1817-1824.

11. Drummond K.E., Murphy E. Minimally invasive cardiac output monitors. Contin. Educ. Anaesth. Crit. Care Pain, 2012, vol. 12, no. 1, pp. 5‒10. URL:https://doi.org/10.1093/bjaceaccp/mkr044

12. Goepfert M.S., Reuter D.A., Akyol D., Lamm P. et al. Goal-directed fluid management reduces vasopressor and catecholamine use in cardiac surgery patients. Int. Care Med., 2007, vol. 33, no. 1, pp. 96-103.

13. Horster S., Stemmler H.J., Strecker N. et al. Cardiac output measurements in septic patients: comparing the accuracy of USCOM to PiCCO. Crit. Care Res. Pract., 2012, URL:http://dx.doi.org/10.1155/2012/270631

14. Lichtenthal P.R., Phillips R.A., Sloniger J.A. et al. USCOM – non invasive doppler – are cardiac output measurements accurate in both infants and adults? Anesthesiology, 2006, vol. 105, pp. A466.

15. Meyer S., Todd D., Wright I. et al. Review article: Non-invasive assessment of cardiac output with portable continuous-wave Doppler ultrasound. Emerg. Med. Australas, 2008, vol. 20, no. 3, pp. 201-208.

16. Otto C.M. Textbook of Clinical Echocardiography. 5th ed., Philadelphia, PA, Elsevier Saunders, 2013, 552 p.

17. Patel N., Dodsworth M., Mills J.F. Cardiac output measurement in newborn infants using the ultrasonic cardiac output monitor: an assessment of agreement with conventional echocardiography, repeatability and new user experience. Arch. Dis. Child Fetal. Neonatal Ed., 2011, vol. 96, no. 3, pp. 206-211.

18. Pölönen P., Ruokonen E., Hippeläinen M. et al. A prospective, randomized study of goal-oriented hemodynamic therapy in cardiac surgical patients. Anesth. Analg., 2000, vol. 90, no. 5, pp. 1052-1059.

19. Thom O., Taylor D.M., Wolfe R.E. et al. Comparison of a supra-sternal cardiac output monitor (USCOM) with the pulmonary artery catheter. Br. J. Anaesth., 2009, vol. 103, no. 6, pp. 800-804.

20. Van Lelyveld-Haas L.E., van Zanten A.R., Borm G.F. et al. Clinical validation of the non-invasive cardiac output monitor USCOM-1A in critically ill patients. Eur. J. Anaesthesiol., 2008, vol. 25, no. 11, pp. 917-924.

21. Van den Oever H.L., Murphy E.J., Christie-Taylor G.A. USCOM (Ultrasonic Cardiac Output Monitors) lacks agreement with thermodilution cardiac output and transoesophageal echocardiography valve measurements. Anaesth. Intens. Care, 2007, vol. 35, no. 6, pp. 903-910.

22. Wongsirimetheekul T., Khositseth A., Lertbunrian R. Non-invasive cardiac output assessment in critically ill paediatric patients. Acta Cardiol., 2014, vol. 69, no. 2, pp. 167-173.

23. Zheng M.L., Sun X., Zhong J. et al. Clinical study of neonatal cardiac output measurement methods. Zhonghua Er Ke Za Zhi, 2013, vol. 51, no. 1, pp. 58-63.


Review

For citations:


Leonov N.P., Strunin O.V., Poletaeva O.V., Lomivorotov V.V., Karaskov A.M. CARDIAC OUTPUT MEASUREMENT IN THE CHILDREN AFTER CARDIAC SURGERY: COMPARISON OF ULTRASOUND MONITORING OF CARDIAC OUTPUT AND ECHOCARDIOGRAPHY. Messenger of ANESTHESIOLOGY AND RESUSCITATION. 2018;15(4):42-47. (In Russ.) https://doi.org/10.21292/2078-5658-2018-15-4-42-47



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