title: Evaluation of the estimated continuous cardiac output monitoring system in adults and children undergoing kidney transplant surgery: a pilot study.
abstract: Evaluation of the estimated continuous cardiac output (esCCO) allows non-invasive and continuous assessment of cardiac output. However, the applicability of this approach in children has not been assessed thus far. We compared the correlation coefficient, bias, standard deviation (SD), and the lower and upper 95 % limits of agreement for esCCO and dye densitography-cardiac output (DDG-CO) measurements by pulse dye densitometry (PDD) in adults and children. On the basis of these assessments, we aimed to examine whether esCCO can be used in pediatric patients. DDG-CO was measured by pulse dye densitometry (PDD) using indocyanine green. Modified-pulse wave transit time, obtained using pulse oximetry and electrocardiography, was used to measure esCCO. Correlations between DDG-CO and esCCO in adults and children were analyzed using regression analysis with the least squares method. Differences between the two correlation coefficients were statistically analyzed using a correlation coefficient test. Bland-Altman plots were used to evaluate bias and SD for DDG-CO and esCCO in both adults and children, and 95 % limits of agreement (bias ± 1.96 SD) and percentage error (1.96 SD/mean DDG-CO) were calculated and compared. The average age of the adult patients (n = 10) was 39.3 ± 12.1 years, while the average age of the pediatric patients (n = 7) was 9.4 ± 3.1 years (p < 0.001). For adults, the correlation coefficient was 0.756; bias, -0.258 L/min; SD, 1.583 L/min; lower and upper 95 % limits of agreement for DDG-CO and esCCO, -3.360 and 2.844 L/min, respectively; and percentage error, 42.7 %. For children, the corresponding values were 0.904; -0.270; 0.908; -2.051 and 1.510 L/min, respectively; and 35.7 %. Due to the high percentage error values, we could not establish a correlation between esCCO and DDG-CO. However, the 95 % limits of agreement and percentage error were better in children than in adults. Due to the high percentage error, we could not confirm a correlation between esCCO and DDG-CO. However, the agreement between esCCO and DDG-CO seems to be higher in children than in adults. These results suggest that esCCO can also be used in children. Future studies with bigger study populations will be required to further investigate these conclusions.
authors: Department of Anesthesiology, Toho University Omori Medical Center, 5-21-16 Omorinishi, Ota-ku, Tokyo, 143-8541, Japan, terada226@med.toho-u.ac.jp.
authors: Takashi
authors: T
authors: Terada
authors: Yumi
authors: Y
authors: Maemura
authors: Akiko
authors: A
authors: Yoshida
authors: Rika
authors: R
authors: Muto
authors: Ryoichi
authors: R
authors: Ochiai
mesh_terms: D000328:Adult; D002138:Calibration; D002302:Cardiac Output; D002648:Child; D003720:Densitometry; D004562:Electrocardiography / Q000379:methods; D005260:Female; D006439:Hemodynamics; D006801:Humans; D007208:Indocyanine Green / Q000737:chemistry; D016030:Kidney Transplantation / Q000379:methods*; D008297:Male; D008875:Middle Aged; D008991:Monitoring, Physiologic / Q000379:methods*; D010092:Oximetry / Q000379:methods; D010477:Perfusion; D010865:Pilot Projects; D063177:Pulse Wave Analysis; D012044:Regression Analysis; D015203:Reproducibility of Results
chemical_list: D007208:Indocyanine Green
references: J Clin Monit Comput. 1999 Dec;15(7-8):493-501
references: 12578047
references: Anesthesiology. 2010 Nov;113(5):1220-35
references: 20881596
references: Anesth Analg. 2009 Mar;108(3):887-97
references: 19224798
references: Annu Int Conf IEEE Eng Med Biol Soc. 2010;2010:2853-6
references: 21095971
references: Pediatr Crit Care Med. 2004 Jul;5(4):343-50
references: 15215003
references: Anesth Analg. 2012 Jul;115(1):82-7
references: 22467885
references: Crit Care Med. 2000 Jun;28(6):2045-50
references: 10890662
references: Circ Res. 1970 May;26(5):611-23
references: 4910134
references: Intensive Care Med. 2003 Nov;29(11):1889-94
references: 12955181
references: J Clin Monit Comput. 2012 Dec;26(6):465-71
references: 22854918
references: Paediatr Anaesth. 2008 Nov;18(11):1019-28
references: 18717806
references: Paediatr Anaesth. 2005 Feb;15(2):125-30
references: 15675929
references: Anesth Analg. 2009 Mar;108(3):707-10
references: 19224773
references: J Clin Monit Comput. 2004 Dec;18(5-6):313-20
references: 15957621