J Clin Monit Comput - Cardiac output assessed by non-invasive monitoring is associated with ECG changes in children with critical asthma.

Tópicos

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Resumo

The primary aim of this study was to determine changes in CI and SI, if any, in children hospitalized with status asthmatics during the course of treatment as measured by non-invasive EC monitoring. The secondary aim was to determine if there is an association between Abnormal CI (defined as <5 or >95 % tile adjusted for age) and Abnormal ECG (defined as ST waves changes) Non-invasive cardiac output (CO) recordings were obtained daily from admission (Initial) to discharge (Final). Changes in CI and SI measurements were compared using paired t tests or 1-way ANOVA. The association between Abnormal CI on Initial CO recording and Abnormal ECG was analyzed by Fischer's exact test. Data are presented as mean ? SEM with mean differences reported with 95 % confidence interval; p < 0.05 was considered significant. Thirty-five children with critical asthma were analyzed. CI decreased from 6.2 ? 0.2 to 4.5 ? 0.1 [-1.6 (-0.04 to -0.37)] L/min/m(2) during hospitalization. There was no change in SI. There was a significant association between Abnormal Initial CI and Abnormal ECG (p = 0.02). In 11 children requiring prolonged hospitalization CI significantly decreased from 7.2 ? 0.5 to 4.0 ? 0.2 [-3.2 (-4.0 to -2.3)] L/min/m(2) and SI decreased from 51.2 ? 3.8 to 40.3 ? 2.0 [-11.0 (-17.6 to -4.4)] ml/beat/m(2) There was a significant decrease in CI in all children treated for critical asthma. In children that required a prolonged course of treatment, there was also a significant decrease in SI. Abnormal CI at Initial CO recording was associated with ST waves changes on ECG during hospitalization. Future studies are required to determine whether non-invasive CO monitoring can predict which patients are at risk for developing abnormal ECG.

Resumo Limpo

primari aim studi determin chang ci si children hospit status asthmat cours treatment measur noninvas ec monitor secondari aim determin associ abnorm ci defin tile adjust age abnorm ecg defin st wave chang noninvas cardiac output co record obtain daili admiss initi discharg final chang ci si measur compar use pair t test way anova associ abnorm ci initi co record abnorm ecg analyz fischer exact test data present mean sem mean differ report confid interv p consid signific thirtyf children critic asthma analyz ci decreas lminm hospit chang si signific associ abnorm initi ci abnorm ecg p children requir prolong hospit ci signific decreas lminm si decreas mlbeatm signific decreas ci children treat critic asthma children requir prolong cours treatment also signific decreas si abnorm ci initi co record associ st wave chang ecg hospit futur studi requir determin whether noninvas co monitor can predict patient risk develop abnorm ecg

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