Determination of cardiac output by ultrasound dilution technique in infants and children: a validation study against direct Fick principle M. Boehne,

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Presentation transcript:

Determination of cardiac output by ultrasound dilution technique in infants and children: a validation study against direct Fick principle M. Boehne, M. Baustert, V. Paetzel, H. Köditz, S. Schoof, C.M. Happel, H. Bertram British Journal of Anaesthesia Volume 112, Issue 3, Pages 469-476 (March 2014) DOI: 10.1093/bja/aet382 Copyright © 2014 The Author(s) Terms and Conditions

Fig 1 Schematic illustration of the COstatus® (UDT) set-up. A sterilized extracorporeal AV loop set primed with heparinized saline connects existing peripheral arterial (radial, ulnar, femoral, or pedal) and venous catheters. On each end of the AV loop, two reusable sterilized sensors for the detection of changes in blood ultrasound velocity and flow were attached. During the measurements, blood circulated through the AV loop by a peristaltic pump at 10–12 ml min−1 from the arterial to the venous side. Randomly over the respiratory cycle, for each measurement, 0.5–1.0 ml kg−1 up to a maximum of 30 ml of pre-warmed isotonic saline from a bag warmer (HFW 1000, Transonic System Inc.) were injected into the venous side of the AV loop. The venous sensor determined the injected volume and the arterial sensor measured the dilution curve, from which CO was calculated by the Stewart–Hamilton equation. At the end of the last measurement, blood was returned to the patient and the AV loop was flushed with heparinized saline. In the study set-up during cardiac catheterization, the AV loop was connected to the side arm of an arterial introducer sheath and a cardiac catheter, which was advanced through a venous sheath with the tip located in the right atrium under fluoroscopic control. (Figure provided by Transonic System Inc.) British Journal of Anaesthesia 2014 112, 469-476DOI: (10.1093/bja/aet382) Copyright © 2014 The Author(s) Terms and Conditions

Fig 2 (a and b) Scatter plot and Bland–Altman plot of CO measurements. (a) Scatter plot of paired CO measurements obtained by direct Fick (COFick) and UDT (COUDT) with the solid line representing linear regression and the dashed line representing the line of identity. (b) Bland–Altman plot of COFick and COUDT. The mean difference between COFick and COUDT was 0.26 litre min−1 (solid line); sd of the difference was 0.47 litre min−1. 95% limits of agreement (dashed line) were −0.66 and 1.19 litre min−1. British Journal of Anaesthesia 2014 112, 469-476DOI: (10.1093/bja/aet382) Copyright © 2014 The Author(s) Terms and Conditions