Measuring cardiac output in children undergoing cardiac catheterization: comparison between the Fick method and PRAM (pressure recording analytical method)

Abstract

Pressure recording analytical method (PRAM) is a novel, arterial pulse contour method for measuring cardiac output (CO). Validation studies of PRAM in children are few, and have shown contradictory results. The aim of the study was to compare the MostCare® -PRAM vs the Fick method of cardiac output estimation (reference method). This is a single-center, prospective observational study in 52 pediatric patients who underwent diagnostic right and left heart catheterization. Cardiac index (CI) measurements with the MostCare® -PRAM vs the Fick method were obtained under hemodynamically stable conditions. Forty CI measurements were performed. The data showed good agreement between CIFick and CIPRAM : r2 = 0.90 (P < 0.001), mean bias -0.075, limits of agreement from -0.56 to 0.41. The percentage error was 17%. Comparable results were obtained for patients <20 kg (r2 = 0.87, P < 0.001), mean bias -0.135, limits of agreement from -0.35 to 0.62, percentage of error 17%. In pediatric patients undergoing diagnostic right and left heart catheterization, the MostCare® -PRAM was shown to estimate CI with a good level of agreement with the Fick method measurements.