Department of Anesthesia, University of Toronto, Toronto, Ontario, Canada.
J Cardiothorac Vasc Anesth. 2011 Oct;25(5):776-9. doi: 10.1053/j.jvca.2011.05.002.
OBJECTIVE(S): To evaluate the measurement of cardiac output (CO) using continuous electrical bioimpedance cardiography (Physioflow; Neumedx, Philadelphia, PA) (CO(PF)) with a simultaneous direct Fick measurement (CO(FICK)) in children with congenital heart disease.
A prospective cohort study comparing 2 methods of measurement of CO.
A quaternary university-affiliated pediatric hospital.
Children undergoing cardiac catheterization for clinical care.
The Physioflow measured continuous real time CO in 15-second epochs and simultaneous measurement of cardiac output by direct Fick (with mass spectrometry to assess VO(2)) were acquired.
Sixty-five patients were recruited, and data from 56 (25 males) were adequate for analysis. The median age at study was 3.5 years (range, 0.4-16.6 years), and the median body surface area was 0.62 m(2) (range, 0.31-1.71). There were 25 of 56 (45%) with univentricular physiology. A total of 19,228 Physioflow data points were available for the analysis of which 14,569 (76%) were valid; 96% of the invalid measurements were identified as artifacts by the device. The average cardiac index of valid measurements was 3.09 ± 0.72 L/min/m(2). Compared with the Fick CO, the mean bias was -0.09 L/min, but the 95% limits of agreement were -3.20 to +3.01 L/min/m(2). Consequently, only 20 of 56 (36%) of measurements were within 20%, and 31 of 56 (55%) of measurements were within 30% of each other.
Compared with measurements made by direct Fick, CO measured using the Physioflow device was unreliable in anesthetized children with congenital heart disease.
评估使用连续电生物阻抗心排量测定仪（Physioflow；Neumedx，费城，宾夕法尼亚州）（CO(PF)）测量先天性心脏病患儿心输出量（CO）的效果，并与直接 Fick 测量（CO(FICK)）进行比较。
前瞻性队列研究，比较 2 种 CO 测量方法。
一家四级大学附属儿童医院。
接受临床治疗的心导管插入术患儿。
Physioflow 在 15 秒的时间段内实时测量连续 CO，并同时进行直接 Fick 测量（使用质谱法评估 VO(2)）。
共招募 65 例患儿，其中 56 例（25 例男性）的数据适合分析。研究时的中位年龄为 3.5 岁（范围，0.4-16.6 岁），中位体表面积为 0.62 m(2)（范围，0.31-1.71）。25 例（45%）为单心室生理学。共获得 19,228 个 Physioflow 数据点，其中 14,569 个（76%）有效；96%的无效测量被设备识别为伪影。有效测量的平均心指数为 3.09±0.72 L/min/m(2)。与 Fick CO 相比，平均偏差为-0.09 L/min，但 95%的一致性界限为-3.20 至+3.01 L/min/m(2)。因此，56 例中仅有 20 例（36%）的测量值在 20%以内，56 例中有 31 例（55%）的测量值在 30%以内。
与直接 Fick 测量相比，麻醉状态下先天性心脏病患儿使用 Physioflow 设备测量的 CO 不可靠。
