Abstract
Background: There is an increased interest in methods of objective cardiac output measurement in pediatric cardiac surgery. Several techniques are available, but have limitations, among the new technologies pressure recording analytical method with MostCare (MostCare-PRAM), a minimally invasive hemodynamic monitoring system, represents a novel arterial pulse contour method that does not require calibration. For this reason, we compared the MostCare-PRAM vs the Fick method for estimation of cardiac output. Methods: We studied prospectively 13 pediatric patients who underwent cardiac surgery and compared intraoperatively Cardiac Index (CI) measured with the MostCare-PRAM with the CI measured with the Fick method. We also measured Cardiac Cycle Efficiency (CCE) and maximal arterial pressure/time ratio (dp/dt max) and compared with Fick method. Results: The data showed good agreement between CI Fick and CI MostCare-PRAM (r = 0.93 and R2= 0.86; p < 0.0001) and also between CCE (r = 0.82 and R2 = 0.67; p < 0.001) and dp/dt (r = 0.84; R2 = 0.81; p < 0.001) with CI measured with Fick method. Conclusion: In pediatric patients submitted to cardiac surgery, the MostCare-PRAM seems to estimate CI with a good level of agreement with the Fick method measurements.
Highlights
It is well known that clinical assessment of cardiac output using indirect parameters of systemic blood flow is beneficial for the patient and reduces morbidity and mortality
In pediatric patients submitted to cardiac surgery, the MostCare-Pressure Recording Analytical Method (PRAM) seems to estimate Cardiac Index (CI) with a good level of agreement with the Fick method measurements
Each patient was successfully transferred in ICU at the end of the surgery and no complications have been found during our follow-up
Summary
It is well known that clinical assessment of cardiac output using indirect parameters of systemic blood flow is beneficial for the patient and reduces morbidity and mortality. Many methods of cardiac output monitoring are available, but not all are feasible in the pediatric population. The aim of this study was to evaluate the reliability of an uncalibrated pulse contour method, PRAM, to measure CO in pediatric patients scheduled for cardiac surgery, compared with the Fick method. But have limitations, among the new technologies pressure recording analytical method with MostCare (MostCare-PRAM), a minimally invasive hemodynamic monitoring system, represents a novel arterial pulse contour method that does not require calibration. For this reason, we compared the MostCare-PRAM vs the Fick method for estimation of cardiac output
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