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Capability of a new paediatric oesophageal Doppler monitor to detect changes in cardiac output during testing of external pacemakers after cardiac surgery

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Abstract

Background

The Cardio QP™ oesophageal Doppler monitor measures the velocity time integral of the blood flow in the descending aorta. Based on system integrated normograms of the aortic cross-sectional area of a paediatric population, the cardiac output is calculated and displayed.

Objective

Evaluation of the capability of the Cardio QP™ to detect changes in cardiac output during desynchronizing ventricular pacing (VVI) in children after cardiac surgery.

Patients

Eleven children (6 female, 5 male) with epicardial pacemaker electrodes admitted to the paediatric intensive care unit (PICU) after corrective surgery for congenital heart defects. Mean age: 6.3 (2.1–15.0) months, mean body weight: 5.3 (3.5–7.8) kg.

Interventions

After baseline measurements of cardiac output (base I), we performed 3 steps, each lasting 5 min: (1) ventricular pacing (VVI), (2) baseline (base II) recording, (3) atrial pacing (AOO). We measured the effects on haemodynamic parameters and blood gases as well as on the measured cardiac output.

Results

Ventricular pacing, with atrio-ventricular dyssynchrony, led to a significant drop in blood pressure and central venous saturation. Cardiac output parameters showed a decrease in stroke volume (SV) from 4.9±2.2 to 4.2±2.1 ml (P = 0.005) and cardiac index (CI) (2.6±1.1–2.1±0.8 ml/min/m2) (P = 0.009) during ventricular pacing. Cardiac index and haemodynamic parameters during atrial stimulation did not show significant changes from baseline.

Conclusion

The Cardio QP™ seems to be capable of detecting slight changes in cardiac output.

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Abbreviations

CHD:

Congenital heart defects

CI:

Cardiac index

CO:

Cardiac output

SD:

Stroke distance

SV:

Stroke volume

TED:

Transoesophageal Doppler

VTI:

Velocity time integral

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Authors and Affiliations

  1. Department of Congenital Heart Disease/Paediatric Cardiology, Deutsches Herzzentrum Berlin, Augustenburger Platz 1, 13353, Berlin, Germany

    Thilo Fleck MD, Stephan Schubert MD, Peter Ewert MD, PhD, Nicole Nagdyman MD, PhD & Felix Berger MD, PhD

  2. Department of Congenital Heart Defects and Paediatric Cardiology, Centre for Paediatrics, University Medical Centre Freiburg, Mathildenstrasse 1, 79106, Freiburg, Germany

    Thilo Fleck MD & Brigitte Stiller MD, PhD

  3. Department of Anaesthesiology, Deutsches Herzzentrum Berlin, Augustenburger Platz 1, 13353, Berlin, Germany

    Matthias Redlin MD

Authors
  1. Thilo Fleck MD
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  2. Stephan Schubert MD
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  3. Brigitte Stiller MD, PhD
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  4. Matthias Redlin MD
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  5. Peter Ewert MD, PhD
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  6. Nicole Nagdyman MD, PhD
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  7. Felix Berger MD, PhD
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Corresponding author

Correspondence to Thilo Fleck MD.

Additional information

Fleck T, Schubert S, Stiller B, Redlin M, Ewert P, Nagdyman N, Berger F. Capability of a new paediatric oesophageal Doppler monitor to detect changes in cardiac output during testing of external pacemakers after cardiac surgery.

Thilo Fleck, Stephan Schubert was contributed equally to this work and should be considered as co-first authors.

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Fleck, T., Schubert, S., Stiller, B. et al. Capability of a new paediatric oesophageal Doppler monitor to detect changes in cardiac output during testing of external pacemakers after cardiac surgery. J Clin Monit Comput 25, 419–425 (2011). https://doi.org/10.1007/s10877-011-9322-0

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  • DOI: https://doi.org/10.1007/s10877-011-9322-0

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