Comparison of cardiac output measurement by electrical cardiometry and pressure recording analytical method and their nursing during pediatric cardiac surgery

Abstract

Objective To evaluate the difference between stroke volume measured by electrical cardiometry-Icon (Osypka Medical, Berlin, Germany) and pressure recording analytical method-MostCare (Vygon, Vytech, Padova, Italy) , and to assess their nursing demand, safety and sutibility. Methods From March to September in 2016, twenty-six infants undergoing open heart surgery using CPB were enrolled. After helping anesthesiologist to complete general anesthesia, invasive arterial pressure monitoring was established to use MostCare. After positioning, four electrodes were placed on patients skin. Stoke volume index along with cardiac index (CI) , heart rate, systolic and diastolic pressure were recorded before surgical incision (t0) , after pericardiotomy (t1) , weaning from CPB and aortic catheter withdrawed (t2) , after skin closure (t3) . Pearson correlations were calculated and agreement were compared by Bland-Altman analysis between the two devices. Meanwhile, by observing and analyzing factors that affect correct readings of the two devices, to eliminate factors related with nursing. Adverse events related to the using of the two devices were recorded. Results No adverse events showed up in surgery, the process of surgery were not affected. Specialized intraoperative nursing ensure the two devices providing reliable and continuous readings. A good linear correlation was found between Icon-and MostCare-SVI at each time point (r=0.84, 0.66, 0.87, 0.81; P<0.001 for all) . At Bland-Altman analysis the mean difference (ml/m2) , 95% limits of agreement (ml/m2) , and percentage error between the two devices at four time points were (-0.4, -8.4-7.6, 27.2%) , (-7.2, -17.4-3.4, 42.6%) , (-1.8, -7.9-4.6, 29.7%) , (-1.2, -6.1-4.0, 25.6%) , respectively. Conclusions In children undergoing open heart surgery, except the period from thoractomy to pre-cardiopulmonary bypass, Icon-and MostCare-SVI readings were interchangeable. Sufficient preoperative preparation, specialized intraoperative nursing can ensure the two devices function safely and correctively. Key words: Nursing care; Cardiac output; Congenital heart disease; Icon; MostCare