Department of Pediatric Anesthesia and Intensive Care, Children´s Hospital, University Hospital of Lund, Lund, Sweden.
Department of Anesthesia and Intensive Care, Landspítalinn, University Hospital of Iceland, Reykjavík, Iceland.
Sci Rep. 2020 Jan 28;10(1):1337. doi: 10.1038/s41598-020-58347-2.
Clinical evaluation of intracardiac shunts in children is not straightforward. Echocardiography can only diagnose the presence of a shunt but does not estimate the shunt ratio. This can be a critical factor that influences treatment options. In this single-center, prospective, observational, method-comparison study, we validate the ability of a novel monitoring device COstatus to estimate the intracardiac shunt ratio (Qp/Qs) of pulmonary (Qp) to systemic (Qs) blood flow in young children before and after corrective cardiac surgery. The indicator dilution technology COstatus monitor was compared to two other more invasive reference techniques, perivascular ultrasonic flow probes (placed around the pulmonary truncus and ascending aorta) and the oximetric shunt equation (using arterial and venous blood gases). Our study revealed that the COstatus monitor detected intracardiac shunts with high sensitivity and specificity but there was some underestimation of the shunt ratios compared to the reference techniques.
儿童心内分流的临床评估并不简单。超声心动图只能诊断分流的存在，但不能估计分流比。这可能是影响治疗选择的关键因素。在这项单中心、前瞻性、观察性、方法比较研究中，我们验证了一种新型监测设备 COstatus 在小儿心脏矫正手术后前后估计肺（Qp）至体循环（Qs）血流的心内分流比（Qp/Qs）的能力。指示剂稀释技术 COstatus 监测仪与另外两种更具侵入性的参考技术进行了比较，这两种参考技术为血管周围超声流量探头（放置在肺动脉干和升主动脉周围）和血氧定量分流方程（使用动脉和静脉血气）。我们的研究表明，COstatus 监测仪对心内分流具有较高的灵敏度和特异性，但与参考技术相比，分流比存在一定程度的低估。
