Transpulmonary thermodilution versus transthoracic echocardiography for cardiac measurements in severely burned children
Model System:
BurnReference Type:
JournalAccession No.:
J78250Journal:
Shock
Year, Volume, Issue, Page(s):
, 46, 3, 249-253Publication Website:
Abstract:
Study compared cardiac output (CO) measurements performed in severely burned children using the transpulmonary thermodilution (TPTD) with the PiCCO (Pulse index Continuous Cardiac Output) system or transthoracic echocardiography (TTE). Fifty-four severely burned children were studied. Outcomes were compared using t-tests, multiple linear regression, and a Bland-Altman plot. An analysis of 105 data pairs revealed that PiCCO yielded higher CO measurements than TTE (190 percent versus 150 percent of predicted values). PiCCO- and TTE-derived CO measurements correlated moderately well (0.54). A Bland-Altman plot showed a mean bias of 1.53 liters per minute with a 95-percent prediction interval of 4.31 liters per minute. TTE-derived estimates of CO may underestimate severity of the hyperdynamic state in severely burned children. The authors recommend using the PiCCO system for objective cardiovascular monitoring and to guide goal-directed fluid resuscitation in this population.
Author(s):
Wurzer, Paul, Branski, Ludwik K., Jeschke, Marc G., Ali, Arham, Kinsky, Michael P., Bohanon, Frederick J., Hundeshagen, Gabriel, Norbury, William B., Williams, Felicia N., Kamolz, Lars-P., Finnerty, Celeste C., Herndon, David N.