Assessment of cardiac output in children: A comparison between the pressure recording analytical method and Doppler echocardiography*


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Abstract

Objective:To assess cardiac output in pediatric patients with the pressure recording analytical method (PRAM) and the Doppler echocardiography method. PRAM derives cardiac output from beat-by-beat analysis of the arterial pressure profile (systolic and diastolic phase) in the time domain.Design:A prospective observational study.Setting:Pediatric intensive care unit at a tertiary care children’s hospital.Patients:Forty-eight patients between the ages of 1 month and 18 yrs.Interventions:Femoral or radial artery catheterization and mechanical ventilation.Measurements and Main Results:Cardiac output was simultaneously estimated by Doppler echocardiography and PRAM. Cardiac output values obtained by Doppler echocardiography (2.7 ± 1.6 L/min, range 0.92–8.20) were significantly correlated with those estimated by PRAM (2.6 ± 1.7 L/min, range 0.89–7.48; r2 = .99, p < .01). The mean difference between the two estimates was 0.12 ± 0.27 L·min−1 (95% confidence interval, −0.54 to 0.77 L·min−1).Conclusions:In the range of ages evaluated, PRAM provides reliable estimates of cardiac output when compared with noninvasive techniques.

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