Doppler determination of cardiac output in infants and children: comparison with simultaneous thermodilution

Ten children, aged six weeks to 13 years, without intracardiac shunts or lesions that could cause turbulent flow in the ascending aorta or aortic regurgitation, underwent cardiac catheterization, including cardiac output measurements by thermodilution. Simultaneously with each of six consecutive thermodilution injections, mean and maximal blood velocities in the ascending aorta were measured by pulsed Doppler echocardiography from the suprasternal notch. Aortic root and aortic orifice diameters were measured with M-mode and cross-sectional echocardiography. One patient had to be excluded from the analysis because of inadequate Doppler recordings. The best agreement with the results of the thermodilution was observed when internal systolic aortic root diameter was combined with mean velocity (r = 0.97, y = 0.90x + 0.28, SEE = 0.31 liters/min). When cardiac output was normalized for body size, there was still a good correlation between the results of these two methods.