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Cardiac output measured by thermodilution in infants and children
Insights
Cardiac output determination by thermodilution (COT) is accurate and reproducible in children. This method is valuable for critically ill infants and children, showing excellent correlation with the Fick technique.
Area of Science:
- Pediatric Cardiology
- Critical Care Medicine
- Medical Device Technology
Background:
- Accurate cardiac output measurement is crucial for managing critically ill children.
- Thermodilution is a common method for cardiac output determination, but its accuracy in pediatric populations requires validation.
Purpose of the Study:
- To assess the accuracy and reproducibility of cardiac output determination by thermodilution (COT) in pediatric patients.
- To compare COT measurements with the established Fick technique (COF) in children undergoing cardiac catheterization.
Main Methods:
- Simultaneous cardiac output measurements were performed using both thermodilution and the Fick technique in 26 children (aged 8-86 months).
- Statistical analysis included correlation (R-value) and percentage difference to evaluate accuracy.
- Reproducibility was assessed by analyzing the standard deviation of serial thermodilution outputs.
Main Results:
- Excellent correlation was observed between COT and COF (R = 0.91), with the equation COT = 1.10 COF - 0.2 l/minute.
- In 75% of patients, COT differed from COF by 15% or less; differences exceeded 25% in no patients.
- Serial COT measurements demonstrated high reproducibility, with a standard deviation of 5.5%.
Conclusions:
- Cardiac output determination by thermodilution is an accurate and reproducible method in pediatric patients.
- COT is a valuable tool for monitoring and managing critically ill infants and children.
- The findings support the clinical utility of thermodilution for cardiac output assessment in pediatric critical care settings.
Abstract:
To determine the accuracy and reproducibility of cardiac output determination by thermodilution (COT) in children, simultaneous outputs were measured by the Fick technique (COF) (using measured oxygen consumption) and thermodilution in 26 children, ranging in age from 8 to 86 months, who were undergoing cardiac catheterization. There was excellent correlation between mean output by thermodilution and by the Fick technique: COT = 1.10 COF -- 0.2 l/minute, R = 0.91. In three-quarters of the patients with COT differed by 15% or less and in none differed by more than 25%. Serial values of thermodilution outputs were reproducible in each patient with a SD of 5.5%. Our observations indicate that COT is accurate, reproducible, and valuable in the care of critically ill infants and children.