Abstract
Introduction: Measuring cardiac output (CO) is an important clinical feature in the neonatal intensive care unit (NICU). Although different clinical methods have been used to evaluate CO clinically, there are no studies validating those results regarding any instrumental method to measure CO. In this prospective study we analyzed the relationship between estimation of CO through clinical methods and Doppler ultrasonography. Material and Methods: 26 patients admitted consecutively in the NICU at Hospital de Pediatría “Prof. J.P.Garrahan” were studied. Inclusion criteria were patients receiving mechanical ventilation with admission longer than 4 hrs. Patient with structural congenital heart disease and those who required reanimation maneuver during the preceding 6 hrs were excluded. CO was classified into normal and low, using a score including physical examination, blood gas, arterial tension and urinary output during the preceding 4 hrs. Ultrasonography measurements were performed 30 min after clinical examination and were the average of 4 examinations, blinded to the clinical method. Sensibility (S), specificity (SP), positive predictive value (PPV), negative predictive value (NPV), and p value were estimated for the clinical method. Results: CO was normal in 20 patients and low in 6 patients. Clinical CO had a S=75%, SP= 88%, PPV=75%, NPV=88%, and p= 0.003. Two patients had normal clinical CO and low CO in ultrasonography evaluation. Two patients had low clinical CO and normal CO in ultrasonographic evaluation, both with ductal shunting. Conclusions: Low CO prevalence in our study sample was not significant. CO measuring in NICU through clinical methods was satisfactory and would be useful to complement CO evaluation in ventilated newborns without structural congenital heart disease.
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Bellani, P., Salgado, G., de Sarasqueta, P. et al. Clinical Score Validation for Detecting Cardiac Output Variations in Ventilated Newborns. Pediatr Res 53, 869 (2003). https://doi.org/10.1203/00006450-200305000-00033
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DOI: https://doi.org/10.1203/00006450-200305000-00033