Validation of cardiac output measurements with noninvasive Doppler echocardiography by thermodilution and Fick methods in newborn piglets

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Abstract

Since cardiac output measured by the noninvasive pulsed Doppler technique has not been well correlated to results from the invasive thermodilution or Fick methods in neonates, the three methods were evaluated in 6 sedated newborn piglets (age ≤ 7 days, weight 1.5 ± 0.7 kg) in room air and after 10 min of hypoxia. Doppler velocities were measured in the ascending aorta, and the aortic root diameter was measured in early diastole. A Swan-Ganz catheter in the left pulmonary artery sampled mixed venous blood for central venous O2 content and measured cardiac output by thermodilution. Oxygen consumption was measured by the open-circuit technique and used to determine cardiac output by the Fick method. In room air, values obtained by pulsed Doppler, thermodilution and Fick methods (0.270 ± 0.05, 0.246 ± 0.05 and 0.241 ± 0.05 liters/kg/min, respectively) were similar, with a correlation coefficient (r) between Doppler and thermodilution values of 0.89, Doppler and Fick values of 0.82 and thermodilution and Fick values of 0.88. Although hypoxia sometimes produced larger differences between paired values, correlation coefficients remained high (Doppler echocardiography vs. thermodilution, r = 0.96; Doppler vs. Fick methods, r = 0.92; thermodilution vs. Fick method, r = 0.95). The mean ± SD of the percent difference between values obtained by Doppler echocardiography and thermodilution was 4.2 ± 14.4% in room air and 12.8 ± 14.4% in hypoxia, whereas differences in values obtained by Doppler and Fick methods was 6 ± 14.9% in room air and 14.7 ± 8.5% with hypoxia. We conclude that pulsed Doppler echocardiography correlates well with the standard invasive methods for measuring cardiac output during normoxia and hypoxia in newborns, but a greater variability between individual results is sometimes seen during hypoxia.

Original languageEnglish
Pages (from-to)137-145
Number of pages9
JournalBiology of the Neonate
Volume66
Issue number2-3
StatePublished - Jan 1 1994

Fingerprint

Thermodilution
Doppler Echocardiography
Cardiac Output
Air
Doppler Pulsed Echocardiography
Diastole
Oxygen Consumption
Pulmonary Artery
Aorta
Hypoxia
Catheters
Weights and Measures

Keywords

  • Cardiac output
  • Doppler sonography
  • Fick method
  • Thermodilution

ASJC Scopus subject areas

  • Developmental Biology
  • Pediatrics, Perinatology, and Child Health

Cite this

@article{671da4301f9744298c039c39eb5f4a43,
title = "Validation of cardiac output measurements with noninvasive Doppler echocardiography by thermodilution and Fick methods in newborn piglets",
abstract = "Since cardiac output measured by the noninvasive pulsed Doppler technique has not been well correlated to results from the invasive thermodilution or Fick methods in neonates, the three methods were evaluated in 6 sedated newborn piglets (age ≤ 7 days, weight 1.5 ± 0.7 kg) in room air and after 10 min of hypoxia. Doppler velocities were measured in the ascending aorta, and the aortic root diameter was measured in early diastole. A Swan-Ganz catheter in the left pulmonary artery sampled mixed venous blood for central venous O2 content and measured cardiac output by thermodilution. Oxygen consumption was measured by the open-circuit technique and used to determine cardiac output by the Fick method. In room air, values obtained by pulsed Doppler, thermodilution and Fick methods (0.270 ± 0.05, 0.246 ± 0.05 and 0.241 ± 0.05 liters/kg/min, respectively) were similar, with a correlation coefficient (r) between Doppler and thermodilution values of 0.89, Doppler and Fick values of 0.82 and thermodilution and Fick values of 0.88. Although hypoxia sometimes produced larger differences between paired values, correlation coefficients remained high (Doppler echocardiography vs. thermodilution, r = 0.96; Doppler vs. Fick methods, r = 0.92; thermodilution vs. Fick method, r = 0.95). The mean ± SD of the percent difference between values obtained by Doppler echocardiography and thermodilution was 4.2 ± 14.4{\%} in room air and 12.8 ± 14.4{\%} in hypoxia, whereas differences in values obtained by Doppler and Fick methods was 6 ± 14.9{\%} in room air and 14.7 ± 8.5{\%} with hypoxia. We conclude that pulsed Doppler echocardiography correlates well with the standard invasive methods for measuring cardiac output during normoxia and hypoxia in newborns, but a greater variability between individual results is sometimes seen during hypoxia.",
keywords = "Cardiac output, Doppler sonography, Fick method, Thermodilution",
author = "E. Welch and Shahnaz Duara and C. Suguihara and Bandstra, {Emmalee S} and Eduardo Bancalari",
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volume = "66",
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T1 - Validation of cardiac output measurements with noninvasive Doppler echocardiography by thermodilution and Fick methods in newborn piglets

AU - Welch, E.

AU - Duara, Shahnaz

AU - Suguihara, C.

AU - Bandstra, Emmalee S

AU - Bancalari, Eduardo

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N2 - Since cardiac output measured by the noninvasive pulsed Doppler technique has not been well correlated to results from the invasive thermodilution or Fick methods in neonates, the three methods were evaluated in 6 sedated newborn piglets (age ≤ 7 days, weight 1.5 ± 0.7 kg) in room air and after 10 min of hypoxia. Doppler velocities were measured in the ascending aorta, and the aortic root diameter was measured in early diastole. A Swan-Ganz catheter in the left pulmonary artery sampled mixed venous blood for central venous O2 content and measured cardiac output by thermodilution. Oxygen consumption was measured by the open-circuit technique and used to determine cardiac output by the Fick method. In room air, values obtained by pulsed Doppler, thermodilution and Fick methods (0.270 ± 0.05, 0.246 ± 0.05 and 0.241 ± 0.05 liters/kg/min, respectively) were similar, with a correlation coefficient (r) between Doppler and thermodilution values of 0.89, Doppler and Fick values of 0.82 and thermodilution and Fick values of 0.88. Although hypoxia sometimes produced larger differences between paired values, correlation coefficients remained high (Doppler echocardiography vs. thermodilution, r = 0.96; Doppler vs. Fick methods, r = 0.92; thermodilution vs. Fick method, r = 0.95). The mean ± SD of the percent difference between values obtained by Doppler echocardiography and thermodilution was 4.2 ± 14.4% in room air and 12.8 ± 14.4% in hypoxia, whereas differences in values obtained by Doppler and Fick methods was 6 ± 14.9% in room air and 14.7 ± 8.5% with hypoxia. We conclude that pulsed Doppler echocardiography correlates well with the standard invasive methods for measuring cardiac output during normoxia and hypoxia in newborns, but a greater variability between individual results is sometimes seen during hypoxia.

AB - Since cardiac output measured by the noninvasive pulsed Doppler technique has not been well correlated to results from the invasive thermodilution or Fick methods in neonates, the three methods were evaluated in 6 sedated newborn piglets (age ≤ 7 days, weight 1.5 ± 0.7 kg) in room air and after 10 min of hypoxia. Doppler velocities were measured in the ascending aorta, and the aortic root diameter was measured in early diastole. A Swan-Ganz catheter in the left pulmonary artery sampled mixed venous blood for central venous O2 content and measured cardiac output by thermodilution. Oxygen consumption was measured by the open-circuit technique and used to determine cardiac output by the Fick method. In room air, values obtained by pulsed Doppler, thermodilution and Fick methods (0.270 ± 0.05, 0.246 ± 0.05 and 0.241 ± 0.05 liters/kg/min, respectively) were similar, with a correlation coefficient (r) between Doppler and thermodilution values of 0.89, Doppler and Fick values of 0.82 and thermodilution and Fick values of 0.88. Although hypoxia sometimes produced larger differences between paired values, correlation coefficients remained high (Doppler echocardiography vs. thermodilution, r = 0.96; Doppler vs. Fick methods, r = 0.92; thermodilution vs. Fick method, r = 0.95). The mean ± SD of the percent difference between values obtained by Doppler echocardiography and thermodilution was 4.2 ± 14.4% in room air and 12.8 ± 14.4% in hypoxia, whereas differences in values obtained by Doppler and Fick methods was 6 ± 14.9% in room air and 14.7 ± 8.5% with hypoxia. We conclude that pulsed Doppler echocardiography correlates well with the standard invasive methods for measuring cardiac output during normoxia and hypoxia in newborns, but a greater variability between individual results is sometimes seen during hypoxia.

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