J Clin Monit Comput - Evaluation of the estimated continuous cardiac output monitoring system in adults and children undergoing kidney transplant surgery: a pilot study.

Tópicos

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Resumo

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.

Resumo Limpo

evalu estim continu cardiac output escco allow noninvas continu assess cardiac output howev applic approach children assess thus far compar correl coeffici bias standard deviat sd lower upper limit agreement escco dye densitographycardiac output ddgco measur puls dye densitometri pdd adult children basi assess aim examin whether escco can use pediatr patient ddgco measur puls dye densitometri pdd use indocyanin green modifiedpuls wave transit time obtain use puls oximetri electrocardiographi use measur escco correl ddgco escco adult children analyz use regress analysi least squar method differ two correl coeffici statist analyz use correl coeffici test blandaltman plot use evalu bias sd ddgco escco adult children limit agreement bias sd percentag error sdmean ddgco calcul compar averag age adult patient n year averag age pediatr patient n year p adult correl coeffici bias lmin sd lmin lower upper limit agreement ddgco escco lmin respect percentag error children correspond valu lmin respect due high percentag error valu establish correl escco ddgco howev limit agreement percentag error better children adult due high percentag error confirm correl escco ddgco howev agreement escco ddgco seem higher children adult result suggest escco can also use children futur studi bigger studi popul will requir investig conclus

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