Year, Volume, Issue, Page(s):16, 46, 3, 249-253
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.