Abstract 18505: Determination of Non Invasive Cardiac Output by Electrical Cardiometry Technique in Acute Hemorrhagic Shock Model
Introduction: The non-invasive continuous determination of stroke volume (SV) in hypovolemic shock would be advantageous in pediatric intensive care. Electrical Cardiometry (EC) detects changes in thoracic bio-impedance and electrical conductivity of aortic blood flow allowing subsequent calculation of SV volumetric variables of preload, such as total end-diastolic volume index (TFC). The objective of this study was to evaluate the accuracy of EC when compared to trans esophageal echocardiogram (TEE) in hemorrhagic shock model.
Hypothesis: SV calculated by EC would be similar to TEE in acute hemorrhagic shock model.
Methods: Nine 3 month old pigglets (~25 Kg) were anesthetized and instrumented to measure heart rate, mean arterial pressure (MAP), SV. SV was measured using EC and TEE using Modified Simpson techniques. After baseline, celiac artery was transectected and ~ 50% of the blood volume was removed (hemorrhagic state), colloid infusion was administered at 10 mls/kg once MAP reached 35 mmHg (resuscitation state). TEE and EC was used to determine SV and TFC at baseline, hemorrhagic and resuscitation state. After evaluation of atrium and ventricular function the cardiologist also submitted a subjective score (0-50points) for pre-load (TPL) at the same time points. Where 0 is poor pre load and 50 is excessive pre load. SV and TPL vs TFC agreement was determined by Blant Altman.
Results: Agreement was determined using Bland Altman analysis. 64 comparisons were made. SV correlation (r2= 0.74) was good between the 2 methods with a mean difference (bias) and precision of -0.8 and 0.85, respectively. TFC correlated well with TPL with bias 1.5 and limits of agreement -36 to 33%.
Conclusions: EC technique is a viable method for measuring cardiac output in patients with acute hemorrhagic shock.
- © 2013 by American Heart Association, Inc.