Accuracy and repeatability of pediatric cardiac output measurement using Doppler: 20-year review of the literature.
OBJECTIVE
Review of the accuracy and repeatability of Doppler cardiac output (CO) measurements in children.


METHODS
Publications in the scientific literature retrieved using a computerized Medline search from 1982-2002 and a manual review of article bibliographies. Studies comparing Doppler flow measurements with thermodilution, Fick, or dye dilution methods in the pediatric critical care setting were identified to assess the bias, precision, and intra- and interobserver repeatability of Doppler CO measurement. Where results were not suitable for comparison and the original measurements available, data were re-analyzed using appropriate statistical methods and presented in comparative tables.


RESULTS
The precision of pediatric Doppler CO measurements compared to thermodilution, dye dilution, or Fick methods is around 30% and repeatability varies from less than 1% to 22%. Bias is generally less than 10% but varies considerably.


CONCLUSIONS
The bias, precision, and repeatability from study to study indicate that Doppler CO measurements are acceptably reproducible in children, with best results when used to track changes rather than absolute values, and using the transesophageal approach.
Chew
Michelle S
MS
Department of Anesthesia and Intensive Care, Lund University Hospital, 22185, Lund, Sweden. mchew@iekf.au.dk
Poelaert
Jan
J
D015982:Bias; D002302:Cardiac Output; D002648:Child; D003422:Critical Care / Q000379:methods / Q000592:standards; D003627:Data Interpretation, Statistical; D004395:Dye Dilution Technique / Q000592:standards; D015150:Echocardiography, Doppler / Q000379:methods / Q000592:standards*; D017548:Echocardiography, Transesophageal / Q000379:methods / Q000592:standards; D006801:Humans; D008991:Monitoring, Physiologic / Q000379:methods / Q000592:standards*; D015203:Reproducibility of Results; D012107:Research Design / Q000592:standards; D012680:Sensitivity and Specificity; D013815:Thermodilution / Q000379:methods / Q000592:standards