1. Giles N Cattermole Colin A Graham, Timothy H Rainer
The normal ranges of cardiovascular parameters measured using the Ultrasonic Cardiac Output Monitor (USCOM)
Giles N Cattermole
Colin A Graham, Timothy H Rainer
10 min + 2 Q&A

2. Disclosure
GNC has received travel and accommodation expenses from Pacific Medical Systems (distributors of USCOM in Hong Kong) for conference/lectures.
CAG and THR have received educational support to develop haemodynamics courses, and the long-term loan of USCOM machines for clinical and research use.

3. USCOM Ultrasonic Cardiac Output Monitor
Rapid non-invasive measurement of central haemodynamic indices:
Cardiac output (CO)
Stroke volume (SV)
Systemic vascular resistance (SVR)

4. Operation
Suprasternal transducer position

5. Screenshot

6. Reference ranges
Based on unpublished data from 500 healthy subjects in rural Australian community.

7. Previous studies
Children (<12y, n=1197) Cattermole GN et al. Crit Care Med 2010; 38:
Adolescents (12-18y, n=590) Ho GY et al. Pediatr Crit Care Med 2013; 14: e
Elderly (60-89y, n=165): Chan CPY et al. BBA Clin 2014:
Of the elderly, only 77 no co-morbidity.
There are no published reference ranges for normal values in adults (aged years) for this device.

8. Objectives
measure cardiovascular indices using USCOM in healthy adults aged years
combine these data with those from our previously published studies, in order to present normal ranges for all ages
establish normal ranges of USCOM-derived variables according to both weight and age

9. Methods
population-based cross-sectional observational study of healthy HK Chinese
USCOM scans were performed to obtain cardiovascular parameters
data from previously published studies (children, adolescents and the elderly) were included
normal ranges were defined as lying between the 2.5th and 97.5th percentiles

10. Subjects New data were collected from 354 adults aged 18-60 (47% male)
From previous studies:
1197 children (aged 0-12, 55% male)
590 adolescents (aged 12-18, 49% male)
77 elderly (aged 60-89, 55% male)
2218 subjects were studied in total (mean age 16.4, range ; 52% male).

11. Centile curves
SV, SVI according to age

12. Centile curves SV, SVI according to weight
LMS method of Cole and Green

13. Reference ranges by weight
<10 kg kg kg kg kg kg
75+ kg n 18 96
299
451
577
686 91 SV
(ml)
16.3
(na)
30.5
( )
40.9
( )
53.1
( )
71.4
( )
77.7
( )
77.8
( )
SVI
(ml.m-2)
37.0
49.3
( )
54.0
( )
56.5
( )
55.4
( )
47.1
( )
39.3
( ) CO
(l.min-1)
2.04
2.97
( )
3.63
( )
4.42
( )
5.56
( )
5.51
( )
5.71
( ) CI
(l.min-1.m-2)
4.43
5.01
( )
4.93
( )
4.69
( )
4.37
( )
3.37
( )
2.91
( )
Handouts with the full tables?

14. Reference ranges by age
0-2.9 years
3-5.9 years
years
years
years
years
60+ years n 65
353
773
460
267
223 77 SV
(ml)
23.0
( )
40.1
( )
59.2
( )
79.0
( )
76.3
( )
68.8
( )
81.8
( )
SVI
(ml.m-2)
44.0
( )
53.3
( )
56.6
( )
52.8
( )
47.1
( )
40.3
( )
51.1
( ) CO
(l.min-1)
2.63
( )
3.68
( )
4.82
( )
6.23
( )
5.42
( )
4.88
( )
5.22
( ) CI
(l.min-1.m-2)
4.71
( )
4.97
( )
4.57
( )
4.13
( )
3.33
( )
2.82
( )
3.30
( )

15. Conclusion
This is the first study to establish normal ranges for USCOM-derived cardiovascular parameters in all age groups
This is the largest study of these parameters in healthy subjects using any method
These data should be useful for physiological research and clinical practice

16. Thanks to... Our colleagues: And all the subjects who took part!
P Y Mia Leung
Grace Y L Ho
Peach W S Lau
Cangel P Y Chan
Stewart S W Chan
Brendan E Smith
And all the subjects who took part!