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[Cardiac output measurement with transtracheal Doppler in children]
I Kobayashi1, S Kawana, H Watanabe
1Department of Anesthesiology, Sapporo Medical College.
Insights
Transtracheal Doppler (TTD) shows promise for cardiac output (CO) measurement in pediatric patients with heart disease, correlating well with thermodilution. However, its accuracy with transthoracic electrical bioimpedance in healthy children requires further investigation.
Area of Science:
- Pediatric Cardiology
- Medical Devices
- Diagnostic Imaging
Background:
- Accurate cardiac output (CO) monitoring is crucial for managing pediatric patients, especially those with congenital or acquired heart conditions.
- Existing methods for CO measurement in children, such as transthoracic electrical bioimpedance (TEB) and thermodilution (TD), have limitations.
- Transtracheal Doppler (TTD) offers a potential alternative for non-invasive CO assessment.
Purpose of the Study:
- To evaluate the accuracy of transtracheal Doppler (TTD) for cardiac output (CO) measurement in pediatric populations.
- To compare TTD-derived CO measurements with established methods: transthoracic electrical bioimpedance (TEB) in healthy children and thermodilution (TD) in children with heart disease.
- To assess the reliability of aortic diameter measurements obtained via TTD in children with heart disease.
Main Methods:
- A comparative study involving pediatric patients.
- Cardiac output was measured using TTD and compared with TEB in normal children.
- Cardiac output was measured using TTD and compared with TD in children with heart disease.
- Aortic diameters were measured using TTD and compared with angiographic data in children with heart disease.
Main Results:
- TTD demonstrated a significant correlation with thermodilution (TD) for cardiac output measurement in children with heart disease (r = 0.65, P < 0.05).
- No significant correlation was found between TTD and transthoracic electrical bioimpedance (TEB) for CO measurement in normal children.
- Aortic diameters measured by TTD showed a significant correlation with angiographic measurements in children with heart disease (r = 0.92, P < 0.05).
- Potential measurement errors in probe positioning and angle may have influenced aortic diameter correlations.
Conclusions:
- Transtracheal Doppler (TTD) shows potential for cardiac output assessment in pediatric patients with heart disease, particularly when correlated with thermodilution.
- Further research is needed to validate TTD's accuracy in healthy children and to address potential sources of error in aortic diameter measurements.
- TTD may serve as a valuable, non-invasive tool for CO monitoring in specific pediatric cardiac populations, pending further validation.
Abstract:
Cardiac output (CO) measurement with transtracheal Doppler (TTD) was compared with that measured by transthoracic electrical bioimpedance (TEB) in normal children, and with that by thermodilution (TD) in children with heart disease. In CO measurement, TTD correlated significantly with TD (r = 0.65, P < 0.05), but not with TEB. Although aortic diameters, which were necessary for CO measurement with TTD, were far from the values in Woezik's nomogram of normal children, they correlated significantly with those measured from angiographies in children with heart disease (r = 0.92, P < 0.05). However, it is assumed that the significant correlation of diameters in children with heart disease might be produced by the offset of measurement errors in position and angle of the Doppler probe.