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. 1992 Feb;67(2):180–184. doi: 10.1136/hrt.67.2.180

Determination of cardiac output by an angle and diameter independent dual beam Doppler technique in critically ill infants.

C F Wippermann 1, D Schranz 1, R Huth 1, F Zepp 1, H Oelert 1, B K Jüngst 1
PMCID: PMC1024751  PMID: 1540440

Abstract

OBJECTIVE--To compare cardiac output measurements in critically ill infants by the dual beam Doppler and thermodilution techniques. DESIGN--Prospective direct comparison of the two techniques. For statistical evaluation one randomly assigned paired measurement of every patient was used. SETTING--Paediatric intensive care unit in a university hospital. PATIENTS--18 infants after open heart surgery aged 4-25 months (weight 4-10 kg). INTERVENTIONS--Cardiac output measurements by dual beam Doppler and thermodilution techniques were performed within 10 minutes of each other and without knowledge of the results of the other methods. Multiple measurements were performed on some patients with a pharmacological or electrophysiological intervention or with a minimum of six hours between each pair of measurements. MEASUREMENTS AND MAIN RESULTS--Three patients were excluded because of an inadequate Doppler signal or a significant residual shunt. Cardiac output measurements ranged from 0.4 to 2.2 l/min for the thermodilution technique and from 0.5 to 2.1 l/min for the dual beam Doppler technique. Agreement between both methods was acceptable. The mean difference between the two methods was 0.026 l/min with two standard deviations ranging from -0.20 to 0.26 l/min. CONCLUSION--The dual beam Doppler technique was shown to have promise for the non-invasive determination of cardiac output in critically ill infants.

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Selected References

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  1. Alverson D. C., Eldridge M., Dillon T., Yabek S. M., Berman W., Jr Noninvasive pulsed Doppler determination of cardiac output in neonates and children. J Pediatr. 1982 Jul;101(1):46–50. doi: 10.1016/s0022-3476(82)80178-9. [DOI] [PubMed] [Google Scholar]
  2. Bland J. M., Altman D. G. Statistical methods for assessing agreement between two methods of clinical measurement. Lancet. 1986 Feb 8;1(8476):307–310. [PubMed] [Google Scholar]
  3. Donovan K. D., Dobb G. J., Newman M. A., Hockings B. E., Ireland M. Comparison of pulsed Doppler and thermodilution methods for measuring cardiac output in critically ill patients. Crit Care Med. 1987 Sep;15(9):853–857. doi: 10.1097/00003246-198709000-00011. [DOI] [PubMed] [Google Scholar]
  4. Evans J. M., Skidmore R., Baker J. D., Wells P. N. A new approach to the noninvasive measurement of cardiac output using an annular array Doppler technique--II. Practical implementation and results. Ultrasound Med Biol. 1989;15(3):179–187. doi: 10.1016/0301-5629(89)90062-8. [DOI] [PubMed] [Google Scholar]
  5. Evans J. M., Skidmore R., Luckman N. P., Wells P. N. A new approach to the noninvasive measurement of cardiac output using an annular array Doppler technique--I. Theoretical considerations and ultrasonic fields. Ultrasound Med Biol. 1989;15(3):169–178. doi: 10.1016/0301-5629(89)90061-6. [DOI] [PubMed] [Google Scholar]
  6. Goldberg S. J., Sahn D. J., Allen H. D., Valdes-Cruz L. M., Hoenecke H., Carnahan Y. Evaluation of pulmonary and systemic blood flow by 2-dimensional Doppler echocardiography using fast Fourier transform spectral analysis. Am J Cardiol. 1982 Dec;50(6):1394–1400. doi: 10.1016/0002-9149(82)90481-7. [DOI] [PubMed] [Google Scholar]
  7. Hottinger C. F., Meindl J. D. Blood flow measurement using the attenuation-compensated volume flowmeter. Ultrason Imaging. 1979 Jan;1(1):1–15. doi: 10.1177/016173467900100101. [DOI] [PubMed] [Google Scholar]
  8. Huntsman L. L., Stewart D. K., Barnes S. R., Franklin S. B., Colocousis J. S., Hessel E. A. Noninvasive Doppler determination of cardiac output in man. Clinical validation. Circulation. 1983 Mar;67(3):593–602. doi: 10.1161/01.cir.67.3.593. [DOI] [PubMed] [Google Scholar]
  9. Levett J. M., Replogle R. L. Thermodilution cardiac output: a critical analysis and review of the literature. J Surg Res. 1979 Dec;27(6):392–404. doi: 10.1016/0022-4804(79)90159-8. [DOI] [PubMed] [Google Scholar]
  10. Loeber C. P., Goldberg S. J., Marx G. R., Carrier M., Emery R. W. How much does aortic and pulmonary artery area vary during the cardiac cycle? Am Heart J. 1987 Jan;113(1):95–100. doi: 10.1016/0002-8703(87)90015-9. [DOI] [PubMed] [Google Scholar]
  11. Looyenga D. S., Liebson P. R., Bone R. C., Balk R. A., Messer J. V. Determination of cardiac output in critically ill patients by dual beam Doppler echocardiography. J Am Coll Cardiol. 1989 Feb;13(2):340–347. doi: 10.1016/0735-1097(89)90509-3. [DOI] [PubMed] [Google Scholar]
  12. Mackenzie J. D., Haites N. E., Rawles J. M. Method of assessing the reproducibility of blood flow measurement: factors influencing the performance of thermodilution cardiac output computers. Br Heart J. 1986 Jan;55(1):14–24. doi: 10.1136/hrt.55.1.14. [DOI] [PMC free article] [PubMed] [Google Scholar]
  13. Maruschak G. F., Potter A. M., Schauble J. F., Rogers M. C. Overestimation of pediatric cardiac output by thermal indicator loss. Circulation. 1982 Feb;65(2):380–383. doi: 10.1161/01.cir.65.2.380. [DOI] [PubMed] [Google Scholar]
  14. Niclou R., Teague S. M., Lee R. Clinical evaluation of a diameter sensing Doppler cardiac output meter. Crit Care Med. 1990 Apr;18(4):428–432. doi: 10.1097/00003246-199004000-00016. [DOI] [PubMed] [Google Scholar]
  15. Notterman D. A., Castello F. V., Steinberg C., Greenwald B. M., O'Loughlin J. E., Gold J. P. A comparison of thermodilution and pulsed Doppler cardiac output measurement in critically ill children. J Pediatr. 1989 Oct;115(4):554–560. doi: 10.1016/s0022-3476(89)80280-x. [DOI] [PubMed] [Google Scholar]
  16. Pollack M. M., Reed T. P., Holbrook P. R., Fields A. I. Bedside pulmonary artery catheterization in pediatrics. J Pediatr. 1980 Feb;96(2):274–276. doi: 10.1016/s0022-3476(80)80824-9. [DOI] [PubMed] [Google Scholar]
  17. Russell A. E., Smith S. A., West M. J., Aylward P. E., McRitchie R. J., Hassam R. M., Minson R. B., Wing L. M., Chalmers J. P. Automated non-invasive measurement of cardiac output by the carbon dioxide rebreathing method: comparisons with dye dilution and thermodilution. Br Heart J. 1990 Mar;63(3):195–199. doi: 10.1136/hrt.63.3.195. [DOI] [PMC free article] [PubMed] [Google Scholar]
  18. Schuster A. H., Nanda N. C. Doppler echocardiographic measurement of cardiac output: comparison with a non-golden standard. Am J Cardiol. 1984 Jan 1;53(1):257–259. doi: 10.1016/0002-9149(84)90723-9. [DOI] [PubMed] [Google Scholar]
  19. Stetz C. W., Miller R. G., Kelly G. E., Raffin T. A. Reliability of the thermodilution method in the determination of cardiac output in clinical practice. Am Rev Respir Dis. 1982 Dec;126(6):1001–1004. doi: 10.1164/arrd.1982.126.6.1001. [DOI] [PubMed] [Google Scholar]

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