Cardiac output monitoring in children: a review

Area of Science:

• Pediatric Critical Care Medicine
• Cardiovascular Physiology
• Medical Device Technology

Background:

• Cardiac output monitoring is crucial for managing critically ill children and detecting clinical deterioration.
• Current invasive monitoring techniques, while effective, carry risks like infection, thrombosis, and vascular injury.
• There is a significant need for safer, non-invasive methods for assessing cardiac output and fluid responsiveness in pediatric patients.

Purpose of the Study:

• To review the current landscape and advancements in non-invasive cardiac output monitoring for infants and children.
• To highlight novel non-invasive technologies as alternatives to traditional invasive monitoring and echocardiography.
• To discuss the potential of emerging technologies in improving perfusion assessment in pediatric critical care.

Main Methods:

• Review of existing literature on invasive and non-invasive cardiac output monitoring techniques in pediatric critical care.
• Evaluation of novel non-invasive cardiac output monitors and their clinical applicability.
• Discussion of adjunctive technologies for perfusion assessment, including near-infrared spectroscopy and photoplethysmography.

Main Results:

• Invasive cardiac output monitoring techniques improve outcomes but are associated with significant risks.
• Several non-invasive monitoring techniques are available and actively being developed for pediatric use.
• Novel non-invasive monitors demonstrate potential to influence clinical practice and offer a safer alternative.

Conclusions:

• Non-invasive cardiac output monitoring presents a promising alternative to invasive methods in pediatric critical care.
• These technologies can aid in physiology-directed management and early detection of clinical deterioration.
• Future research should focus on refining perfusion assessment technologies like NIRS and photoplethysmography for clinical integration.