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Updated: Dec 6, 2025
Non-invasive Optical Measurement of Cerebral Metabolism and Hemodynamics in Infants
Published on: March 14, 2013
Indexing haemodynamic variables in young children
Theodor S Sigurdsson1,2, Lars Lindberg1
1Department of Paediatric Anaesthesiology and Intensive Care Medicine, Lund Children´s Hospital, Skåne University Hospital, Lund, Sweden.
Insights
Indexing pediatric hemodynamic variables with body weight (BW) offers a more accurate body size-independent scale than body surface area (BSA) in young children. This study found BW indexing provides a more linear relationship for key hemodynamic measures across different weight groups.
Area of Science:
- Pediatric Cardiology
- Hemodynamics
- Physiological Measurements
Background:
- Hemodynamic studies in children are limited, especially in the youngest age groups.
- Establishing population-valid references for hemodynamic variables requires appropriate indexing.
- Traditional indexing with body surface area (BSA) is problematic in young children due to its non-linear relationship with body weight (BW).
Purpose of the Study:
- To examine the effectiveness of indexing hemodynamic variables with both BSA and BW in children.
- To compare the linearity and appropriateness of BSA vs. BW indexing for hemodynamic assessment in pediatric patients.
Main Methods:
- A single-center, observational cohort study involving 68 children undergoing heart surgery.
- Hemodynamic variables were measured and indexed using both BSA and BW.
- Children were stratified into three weight groups: 1-5 kg, >5-10 kg, and >10-15 kg.
Main Results:
- All measured hemodynamic variables (cardiac output, stroke volume, blood volumes) increased with weight when non-indexed.
- Indexing with BW resulted in a more linear relationship for all hemodynamic variables across weight groups compared to BSA indexing.
- Specific mean values for BSA-indexed and BW-indexed hemodynamic variables were reported.
Conclusions:
- Indexing hemodynamic variables with BW provides a more suitable body size-independent scale for young children than BSA.
- BW indexing enhances the reliability of hemodynamic assessment in pediatric surgical patients.
Background:
Haemodynamic studies in children are rare and most studies have included few subjects in the youngest age group. Haemodynamic variables need to be indexed to establish a reference of normality that is valid in all populations. The traditional way to index haemodynamic variables with body surface area (BSA) is complicated in young children due to its non-linear relationship with body weight (BW). We examined several haemodynamic variables in children by indexing them with BSA and BW.
Methods:
A single-centre, observational cohort study comparing non-indexed and indexed haemodynamic variables in children undergoing heart surgery (divided into three weight groups: 1-5 kg, >5-10 kg and >10-15 kg).
Results:
A total of 68 children were included in this study, mean age 11.1 months ± 11.1 month (range 0 to 43 months). All haemodynamic variables, cardiac output (CO), stroke volume (SV), total end-diastolic volume (TEDV), central blood volume (CBV) and active circulation volume (ACV), increased with weight without indexing (P < .05). Indexing variables with BW produced a more linear relationship for all haemodynamic variables between weight groups than BSA. The mean BSA-indexed haemodynamic values were CIBSA 3.5 ± 1.1 L/min/m2 and SVIBSA 27.3 ± 8.9 ml/min/m2 . The mean BW-indexed haemodynamic values were CIBW 180 ± 50 ml/min/kg and SVIBW 1.34 ± 0.38 ml/kg. Blood volume variables indexed with BW were TEDVBW 12.0 ± 2.8 ml/kg, CBVBW 21.3 ± 6.6 ml/kg and ACVBW 70.3 ± 15.2 ml/kg.
Conclusions:
Indexing haemodynamic variables with BW produces a more appropriate body size-independent scale in young children than BSA.
Summary Statement:
In this study, we studied indexing of haemodynamic variables and estimation of blood volumes in young children undergoing corrective heart surgery using an indicator dilution technology.
