title: Noninvasive assessment of cardiac output in children using impedance cardiography.
abstract: This study evaluated the effect of intracardiac shunting on the accuracy of thoracic bioimpedance-derived cardiac output determinations. Twenty-six patients, ranging in age from 3 months to 17 years, underwent cardiac catheterization during which simultaneous Fick and impedance measurements of cardiac output were obtained. The subjects were divided into three groups: 10 children with no intracardiac shunts, nine children with predominant left-to-right intracardiac shunts, and seven children with predominant right-to-left intracardiac shunts. Positive correlations between impedance and Fick-derived cardiac output determinations were obtained in the non-shunt group (r = 0.84), with lower correlations in the left-to-right shunt group (r = 0.70). In the right-to-left shunt group, the impedance derived cardiac output correlated with Fick pulmonary flow (r = 0.82), but the variability was unacceptably large. Although further study is needed, impedance cardiography appears to have validity as a methodology in pediatric critical care and cardiovascular health research.
authors.affiliation: Section of Cardiology, Medical College of Georgia, Augusta 30912-3710.
authors.forename: D S
authors.initials: DS
authors.lastname: Braden
authors.forename: L
authors.initials: L
authors.lastname: Leatherbury
authors.forename: F A
authors.initials: FA
authors.lastname: Treiber
authors.forename: W B
authors.initials: WB
authors.lastname: Strong
mesh_terms: D000293:Adolescent; D002302:Cardiac Output; D002307:Cardiography, Impedance; D002648:Child; D002675:Child, Preschool; D005069:Evaluation Studies as Topic; D005260:Female; D006343:Heart Septal Defects / Q000503:physiopathology*; D006801:Humans; D007223:Infant; D008297:Male