title: Electrical Cardiometry: A Reliable Solution to Cardiac Output Estimation in Children With Structural Heart Disease.
abstract: OBJECTIVE
  Comparison of cardiac output (CO) obtained using electric cardiometry (EC) and pulmonary artery catheterization (PAC) in pediatric patients with congenital structural heart disease.
  
  
  METHODS
  Prospective, observational study.
  
  
  METHODS
  A tertiary hospital.
  
  
  METHODS
  The study comprised 50 patients scheduled to undergo cardiac catheterization.
  
  
  METHODS
  CO data triplets were obtained simultaneously from the cardiometry device ICON (Osypka Medical, Berlin, Germany) and PAC at the following predefined time points-(1) T1: 5 minutes after arterial and venous cannulation and (2) T2: 5 minutes postprocedure; the average of the 3 readings was calculated. Reliability analysis and Bland-Altman analysis were performed to determine the limits of agreement, mean bias, and accuracy of the CO measured with EC.
  
  
  RESULTS
  The measured EC-cardiac index 4.22 (3.84-4.60) L/min/m2and PAC-cardiac index 4.26 (3.67-4.67) L/min/m2were statistically insignificant (p value>0.05) at T1. Bland-Altman analysis revealed a mean bias of 0.0051 L/min/m2and precision limits of±0.4927 L/min/m2. The intraclass correlation coefficient was 0.789 and Cronbach's alpha was 0.652, indicating good reproducibility and internal consistency between the two techniques. Postcatheterization analysis also revealed strong agreement and reliability between the two techniques.
  
  
  CONCLUSIONS
  This study demonstrated that cardiac indices measured in children with a variety of structural heart diseases using EC reliably represent absolute values obtained using PAC. EC technology is simple and easy to use and offers noninvasive beat-to-beat tracking of CO and other hemodynamic parameters in children with structurally abnormal hearts.
authors.affiliation: Department of Cardiac Anesthesiology, Cardio and Neuro Sciences Centre, All India Institute of Medical Sciences, New Delhi, India. Electronic address: jatin.narula.13@gmail.com.
authors.forename: Jitin
authors.initials: J
authors.lastname: Narula
authors.affiliation: Department of Cardiac Anesthesiology, Cardio and Neuro Sciences Centre, All India Institute of Medical Sciences, New Delhi, India.
authors.forename: Sandeep
authors.initials: S
authors.lastname: Chauhan
authors.affiliation: Department of Cardiology, Cardio and Neuro Sciences Centre, All India Institute of Medical Sciences, New Delhi, India.
authors.forename: Sivasubramanian
authors.initials: S
authors.lastname: Ramakrishnan
authors.affiliation: Department of Cardiology, Cardio and Neuro Sciences Centre, All India Institute of Medical Sciences, New Delhi, India.
authors.forename: Saurabh Kumar
authors.initials: SK
authors.lastname: Gupta
mesh_terms: D000293:Adolescent; D001783:Blood Flow Velocity / Q000502:physiology; D006328:Cardiac Catheterization / Q000379:methods; D002302:Cardiac Output / Q000502:physiology*; D002407:Catheterization, Swan-Ganz / Q000379:methods; D002648:Child; D017097:Electric Impedance; D005260:Female; D006330:Heart Defects, Congenital / Q000175:diagnosis* / Q000503:physiopathology* / Q000601:surgery; D006801:Humans; D008297:Male; D011446:Prospective Studies; D015203:Reproducibility of Results; D012212:Rheology / Q000379:methods*
keywords: congenital heart disease; electric velocimetry; noninvasive; pediatric cardiac output monitoring; pulmonary artery catheter; thoracic electrical bioimpedance