Correlation analysis of noninvasive cardiac output monitoring and echocardiogram in evaluation of cardiac function in children with septic shock / 中国小儿急救医学

ABSTRACT

Objective To explore the application value of noninvasive cardiac output monitoring (NICOM) in children with sepsis. Methods A total of 51 children with sepsis admitted to pediatric inten-sive care unit in Chengdu Women and Children's Center Hospital were enrolled. They were divided into three groupssepsis without cardiovascular functional disorder group( sepsis group,n＝16),septic shock compen-sation group (n＝22),septic shock decompensation group (n＝13). The cardiac function of the children was detected by NICOM and echocardiography at the time of admission 0 hours and 1 hours after admission re-spectively. Cardiac index (CI),stroke volume(SV) measured by NICOM and ejection fraction (EF),SV measured by echocardiography were recorded. The correlation between CI and EF at 0 hours and 1 hours after admission was analyzed,and the SV measured by the two methods were compared. Results (1) In the sep-sis group,the CI measured by NICOM was(3. 54 ± 0. 36) L/( min·m2) and EF measured by echocardio-graphy was (66. 9 ± 4. 4)%. There was a significant positive correlation between CI and EF(r＝0. 941,P<0.01).(2) In the septic shock compensation group,CI was (2.40 ±0.36) L/(min·m2) and EF was (51. 91 ± 4. 38)% at 0 hours after admission,and there was a positive correlation between CI and EF( r＝0. 751,P＝0. 023). CI was(2. 98 ±0. 37)L/(min·m2)and EF was(59. 41 ±4. 39)% at 1 hours after admis-sion,and there was a positive correlation between CI and EF (r＝0. 879,P＝0. 012). At 0 hours and 1 hours after admission,the value of SV measured by NICOM was very close to that measured by echocardiography, and there was no significant difference(P>0. 05). (3) In the septic shock decompensation group,CI was (1.26 ±0.28) L/(min·m2) and EF was (41.23 ±4.73)% at 0 hours after admission,and there was no positive correlation between CI and EF(r＝0. 515,P＝0. 121). CI was(1. 61 ± 0. 32)L/(min·m2)and EF was(47. 77 ± 6. 19)% at 1 hours after admission,and there was no positive correlation between CI and EF (r＝0. 531,P＝0. 085). There was significant difference between the value of SV measured by NICOM and that measured by echocardiography at 0 hours and 1 hours after admission (P<0. 05). Conclusion NICOM can accurately evaluate cardiac output when the hemodynamics is stable,but the results are not accurate when the hemodynamics is unstable. NICOM has certain application value in pediatric critical care.