Cardiac output estimates in the pediatric intensive care unit using a continuous-wave Doppler computer: validation and limitations of the technique.

We compared the cardiac index obtained by means of a continuous-wave Doppler computer with simultaneous thermodilution measurements in 25 children in the pediatric intensive care unit (40 observations). The aortic diameter was measured at various levels to determine which provided the best measure of cardiac index. The Doppler measurements were performed independently by a physician trained in Doppler cardiography and by a nurse with no experience in echocardiography. Both the nurse and physician obtained high-quality flow velocity recordings in all patients in a mean time of 5 minutes or less. Cardiac index and total systemic vascular resistance measured by means of Doppler and thermodilution techniques were highly correlated (r = 0.86 and r = 0.93, respectively). The highest correlation was obtained when Doppler cardiac index was computed by means of the internal diameter measured at the aortic anulus. There was no significant difference between the nurse's and physician's measurements. We conclude that cardiac index can be accurately determined in the pediatric intensive care unit by means of continuous-wave Doppler computer, even when operated by personnel not trained in Doppler cardiography.