title: Capability of a new paediatric oesophageal Doppler monitor to detect changes in cardiac output during testing of external pacemakers after cardiac surgery.
abstract: BACKGROUND
  The Cardio QP™ oesophageal Doppler monitor measures the velocity time integral of the blood flow in the descending aorta. Based on system integrated normograms of the aortic cross-sectional area of a paediatric population, the cardiac output is calculated and displayed.
  
  
  OBJECTIVE
  Evaluation of the capability of the Cardio QP™ to detect changes in cardiac output during desynchronizing ventricular pacing (VVI) in children after cardiac surgery.
  
  
  METHODS
  Eleven children (6 female, 5 male) with epicardial pacemaker electrodes admitted to the paediatric intensive care unit (PICU) after corrective surgery for congenital heart defects. Mean age: 6.3 (2.1-15.0) months, mean body weight: 5.3 (3.5-7.8) kg.
  
  
  METHODS
  After baseline measurements of cardiac output (base I), we performed 3 steps, each lasting 5 min: (1) ventricular pacing (VVI), (2) baseline (base II) recording, (3) atrial pacing (AOO). We measured the effects on haemodynamic parameters and blood gases as well as on the measured cardiac output.
  
  
  RESULTS
  Ventricular pacing, with atrio-ventricular dyssynchrony, led to a significant drop in blood pressure and central venous saturation. Cardiac output parameters showed a decrease in stroke volume (SV) from 4.9±2.2 to 4.2±2.1 ml (P = 0.005) and cardiac index (CI) (2.6±1.1-2.1±0.8 ml/min/m(2)) (P = 0.009) during ventricular pacing. Cardiac index and haemodynamic parameters during atrial stimulation did not show significant changes from baseline.
  
  
  CONCLUSIONS
  The Cardio QP™ seems to be capable of detecting slight changes in cardiac output.
authors.affiliation: Department of Congenital Heart Disease/Paediatric Cardiology, Deutsches Herzzentrum Berlin, Augustenburger Platz 1, 13353, Berlin, Germany. thilo.fleck@uniklinik-freiburg.de
authors.forename: Thilo
authors.initials: T
authors.lastname: Fleck
authors.forename: Stephan
authors.initials: S
authors.lastname: Schubert
authors.forename: Brigitte
authors.initials: B
authors.lastname: Stiller
authors.forename: Matthias
authors.initials: M
authors.lastname: Redlin
authors.forename: Peter
authors.initials: P
authors.lastname: Ewert
authors.forename: Nicole
authors.initials: N
authors.lastname: Nagdyman
authors.forename: Felix
authors.initials: F
authors.lastname: Berger
mesh_terms: D002302:Cardiac Output; D006348:Cardiac Surgical Procedures; D004867:Equipment Design; D019544:Equipment Failure Analysis; D005260:Female; D006801:Humans; D007223:Infant; D008297:Male; D016343:Monitoring, Intraoperative / Q000295:instrumentation*; D010372:Pediatrics / Q000295:instrumentation*; D011182:Postoperative Care / Q000295:instrumentation; D015203:Reproducibility of Results; D012212:Rheology / Q000295:instrumentation*; D012680:Sensitivity and Specificity; D018608:Ultrasonography, Doppler / Q000295:instrumentation*
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