Hostname: page-component-cd9895bd7-gxg78 Total loading time: 0 Render date: 2024-12-28T19:39:11.306Z Has data issue: false hasContentIssue false
  • English
  • Français

Continuous monitoring of cardiac output in neonates using an intra-aortic Doppler probe

Published online by Cambridge University Press:  19 August 2008

P Ewert ,
N Nagdyman ,
T Fischer ,
L Gortner  and
PE Lange
P Ewert*
Affiliation:
German Heart Institute, Department of Congenital Heart Defects, Berlin, Germany
N Nagdyman
Affiliation:
German Heart Institute, Department of Congenital Heart Defects, Berlin, Germany
T Fischer
Affiliation:
German Heart Institute, Department of Anesthesiology, Berlin, Germany
L Gortner
Affiliation:
German Heart Institute, Department of Congenital Heart Defects, Berlin, Germany
PE Lange
Affiliation:
German Heart Institute, Department of Congenital Heart Defects, Berlin, Germany
*
P Ewert, MD, Department of Pediatric Cardiology, Deutsches Herzzentrum, Augustenburger Platz 1, 13353 Berlin, Germany. Tel: 49–30–4593–2800; Fax: 49–30–4593–2900
Get access Rights & Permissions [Opens in a new window]

Abstract

Continuous monitoring of cardiac output in neonates would be of considerable benefit but, as yet, there is no practical method to achieve this aim. We have now evaluated the feasibility of using an intra-aortic Doppler probe. We introduced a pulsed Doppler probe of 0.46 mm diameter via the umbilical artery in two term and four preterm neonates. Indications in all patients for umbilical arterial catheter is always an unstable cardiopulmonary state. Body weights were between 770 and 3340 g. Velocities of blood flow in the thoracic aorta were continuously recorded to estimate cardiac output on-line for 12 h. No complications were encountered. It proved possible to derive high-quality Doppler curves. The received Doppler signal was stable but it proved sensitive to pathophysiologic changes in flow. Mean velocity of flow in the descending aorta was 16.4 cm/s (range 13.3_19.0 cm/s). We quantified flow by multiplying the mean velocity of the flow by the cross-sectional area of the descending aorta. Calculated mean flow was 135 ml/kg/min (range 111–179 ml/kg/min). These values are consistent with those measured by transcutaneous Doppler, and it should not be raised by left-to-right ductal shunts. This pilot study proved the feasibility of continuous monitoring of cardiac output. The technique should prove of great value in those infants with unstable circulatory conditions, and can be used even in infants with extremely low birth weights.

Keywords

Intraluminal Doppler ultrasoundhaemodynamic monitoringcardiac outputpreterm infantsneonates
Type
Original Articles
Information
Cardiology in the Young , Volume 9 , Issue 1 , January 1999 , pp. 42 - 48
Copyright
Copyright © Cambridge University Press 1999

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

1.Alverson, DC, Eldridge, MW, Dillon, T.Noninvasive pulsed Doppler determination of cardiac output in premature infants. J Pediatr 1982; 101: 46.CrossRefGoogle Scholar
2.Alverson, DC.Noninvasive measurement of cardiac output in the newborn. J Perinatol 1984; 4: 16–20.Google Scholar
3.Doucette, JW, Corl, D, Payne, HM, Flynn, AE, Goto, M, Nassi, M, Segal, J.Validation of a Doppler guide wire for intravascu- lar measurement of coronary artery flow velocity. Circulation 1992; 85: 1899–1911.CrossRefGoogle Scholar
4.Wessel, DL, Elixson, EM, Hansen, DD, Hickey, PR.A double lumen transthoracic pulmonary artery catheter for measurement of cardiac output in infants and neonates. Anesthesiology 1988; 69: A233.CrossRefGoogle Scholar
5.Huntsman, LL, Stewart, DK, Barnes, SR, Franklin, SB, Colocousis, JS, Hessel, EA.Noninvasive Doppler determination of cardiac output in man. Circulation 1983; 67: 593–602.CrossRefGoogle ScholarPubMed
6.Rein, AJ, Hsieh, KS, Elixon, M, Colan, SD, Lang, P, Sanders, SP, Castaneda, AR.Cardiac Output estimates in the pediatric intensive care unit using a continuous-wave Doppler computer: validation and limitations of the technique. Am Heart J 1986; 112: 97–103.CrossRefGoogle ScholarPubMed
7.Wong, DH, Mahutte, CK.Two-beam pulsed Doppler cardiac output measurement: Reproducibility and agreement with thermodilution. Crit Care Med 1990; 18: 433–37.CrossRefGoogle ScholarPubMed
8.Skinner, JR, Hunter, S, Heten, . Regulation of cardiac output in the neonate: stroke volume or heart rate? Pediatr Cardiol 1991; 12: 258.Google Scholar
9.Walther, FJ, Siassi, B, Ramadan, NA, Ananda, AK, Wu, PY.Pulsed Doppler determination of cardiac output in neonates: normal standards for clinical use. Pediatrics 1985; 76: 829–833.CrossRefGoogle ScholarPubMed
10.Schuster, AH, Nanda, NC.Doppler echocardiographic measurement of cardiac output: comparison with a non-golden standard. Am J Cardiol 1984; 53: 257–259.CrossRefGoogle ScholarPubMed
11.Hade, L, Angelsen, B.Doppler Ultrasound in Cardiology: Physical Principles and Clinical Applications. Lea & Febiger, Philadelphia, 1982, pp 76–193.Google Scholar
12.Seear, M, Webber, S, Leblanc, J.Descending aortic blood flow velocity as a noninvasive measure of cardiac output in children. Pediatr Cardiol 1994; 15: 178–183.CrossRefGoogle ScholarPubMed