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Cattermole GN, Leung PYM, Ho GYL, Lau PWS, Chan CPY, Chan SSW, Smith BE, Graham CA, Rainer TH. The normal ranges of cardiovascular parameters measured using the ultrasonic cardiac output monitor. Physiol Rep 2017; 5:5/6/e13195. [PMID: 28320891 PMCID: PMC5371563 DOI: 10.14814/phy2.13195] [Citation(s) in RCA: 57] [Impact Index Per Article: 8.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/29/2016] [Revised: 01/30/2017] [Accepted: 02/14/2017] [Indexed: 11/24/2022] Open
Abstract
The ultrasonic cardiac output monitor (USCOM) is a noninvasive transcutaneous continuous wave Doppler method for assessing hemodynamics. There are no published reference ranges for normal values in adults (aged 18-60 years) for this device. This study aimed to (1) measure cardiovascular indices using USCOM in healthy adults aged 18-60 years; (2) combine these data with those for healthy children (aged 0-12), adolescents (aged 12-18), and the elderly (aged over 60) from our previously published studies in order to present normal ranges for all ages, and (3) establish normal ranges of USCOM-derived variables according to both weight and age. This was a population-based cross-sectional observational study of healthy Chinese subjects aged 0.5-89 years in Hong Kong. USCOM scans were performed on all subjects, to produce measurements including stroke volume, cardiac output, and systemic vascular resistance. Data from previously published studies (children, adolescents, and the elderly) were included. Normal ranges were defined as lying between the 2.5th and 97.5th percentiles. A total of 2218 subjects were studied (mean age = 16.4, range = 0.5-89; 52% male). From previous studies, 1197 children (aged 0-12, 55% male), 590 adolescents (aged 12-18, 49% male), and 77 elderly (aged 60-89, 55% male) were included. New data were collected from 354 adults aged 18-60 (47% male). Normal ranges are presented according to age and weight. We present comprehensive normal ranges for hemodynamic parameters obtained with USCOM in healthy subjects of all ages from infancy to the elderly.
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Affiliation(s)
- Giles N Cattermole
- Emergency Department, Centre Hospitalier Universitaire de Kigali, Kigali, Rwanda
| | - P Y Mia Leung
- Department of Medicine, Austin/Northern Health, Melbourne, Australia
| | - Grace Y L Ho
- Department of Medicine, Western Health, Melbourne, Australia
| | - Peach W S Lau
- Accident and Emergency Department, Queen Elizabeth Hospital, Hong Kong SAR
| | - Cangel P Y Chan
- Accident and Emergency Medicine Academic Unit, Prince of Wales Hospital, The Chinese University of Hong Kong, Hong Kong SAR
| | - Stewart S W Chan
- Accident and Emergency Medicine Academic Unit, Prince of Wales Hospital, The Chinese University of Hong Kong, Hong Kong SAR
| | - Brendan E Smith
- School of Medicine, University of Notre Dame Australia, Sydney, New South Wales, Australia.,Intensive Care Unit, Bathurst Base Hospital, Bathurst, New South Wales, Australia
| | - Colin A Graham
- Accident and Emergency Medicine Academic Unit, Prince of Wales Hospital, The Chinese University of Hong Kong, Hong Kong SAR
| | - Timothy H Rainer
- Accident and Emergency Medicine Academic Unit, Prince of Wales Hospital, The Chinese University of Hong Kong, Hong Kong SAR.,University Hospital of Wales, Heath Park, Heath, Cardiff, U.K
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Beltramo F, Menteer J, Razavi A, Khemani RG, Szmuszkovicz J, Newth CJL, Ross PA. Validation of an Ultrasound Cardiac Output Monitor as a Bedside Tool for Pediatric Patients. Pediatr Cardiol 2016; 37:177-83. [PMID: 26364291 DOI: 10.1007/s00246-015-1261-y] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/16/2015] [Accepted: 08/27/2015] [Indexed: 12/13/2022]
Abstract
The aim of our study was to determine the validity of cardiac output (CO) measurements taken with the ultrasonic cardiac output monitor (USCOM) by comparing to CO measured by pulmonary arterial catheter (PAC) thermodilution during cardiac catheterization. We enrolled thirty-one children (<18 years) undergoing cardiac catheterization in this double-blinded, prospective, observational study. The median CO measured by USCOM was 4.37 L/min (IQR 3.73, 5.60 L/min) compared to 4.28 L/min (IQR 3.52, 5.26 L/min) by PAC thermodilution. The bias (mean difference) between the two methods was 0.2 L/min, and the 95% limits of agreement were -1.2 to 1.6 L/min. The mean percentage error of CO between USCOM and PAC thermodilution was 11%. When excluding a sole outlier, the bias between the two measures decreased to 0.1 L/min (95% limits of agreement -0.6 to 0.9 L/min), and the percentage error was reduced to 8%. The median SVRI measured by USCOM was 22.0 Wood Units (IQR 17.0, 26.8 Wood Units) compared to 22.1 Wood Units (IQR 17.6, 27.4 Wood Units) by PAC thermodilution. Bias (mean difference) between the two methods was -0.6 Wood Units, and the 95% limits of agreement were -8.2 to 6.9 Wood Units. We found that the estimation of CO and by extension SVRI with USCOM is reliable against pulmonary artery catheter thermodilution in children with normal cardiac anatomy. Given the noninvasive nature of USCOM, speed of measurement, and relative ease of use, it may be useful as a bedside tool for pediatric patients.
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Affiliation(s)
- Fernando Beltramo
- Children's Hospital Los Angeles, 4650 West Sunset Boulevard, Mailstop # 3, Los Angeles, CA, 90027, USA
| | - Jondavid Menteer
- Children's Hospital Los Angeles, 4650 West Sunset Boulevard, Mailstop # 3, Los Angeles, CA, 90027, USA.,University of Southern California Keck School of Medicine, Los Angeles, CA, USA
| | - Asma Razavi
- Children's Hospital Los Angeles, 4650 West Sunset Boulevard, Mailstop # 3, Los Angeles, CA, 90027, USA
| | - Robinder G Khemani
- Children's Hospital Los Angeles, 4650 West Sunset Boulevard, Mailstop # 3, Los Angeles, CA, 90027, USA.,University of Southern California Keck School of Medicine, Los Angeles, CA, USA
| | - Jacqueline Szmuszkovicz
- Children's Hospital Los Angeles, 4650 West Sunset Boulevard, Mailstop # 3, Los Angeles, CA, 90027, USA.,University of Southern California Keck School of Medicine, Los Angeles, CA, USA
| | - Christopher J L Newth
- Children's Hospital Los Angeles, 4650 West Sunset Boulevard, Mailstop # 3, Los Angeles, CA, 90027, USA.,University of Southern California Keck School of Medicine, Los Angeles, CA, USA
| | - Patrick A Ross
- Children's Hospital Los Angeles, 4650 West Sunset Boulevard, Mailstop # 3, Los Angeles, CA, 90027, USA. .,University of Southern California Keck School of Medicine, Los Angeles, CA, USA.
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