Changes in cardiac output and stroke volume as measured by non-invasive CO monitoring in infants with RSV bronchiolitis

Caplow, Julie; McBride, Sarah; Steil, Garry M.; Wong, Jackson

doi:10.1007/s10877-012-9361-1

Cited by 11 publications

(6 citation statements)

References 38 publications

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“…Cardiovascular complications are described in up to 9% of hospitalized patients [ 26 ]. Significant cardiac output and stroke volume changes have been demonstrated in infants without heart disease who were hospitalized for bronchiolitis in relation with their respiratory distress [ 27 ]. Up to 50% of patients have a positive troponin or NT-proBNP assay at the time of hospitalization.…”

Section: Discussionmentioning

confidence: 99%

Characterization of Cardiopulmonary Interactions and Exploring Their Prognostic Value in Acute Bronchiolitis: A Prospective Cardiopulmonary Ultrasound Study

et al. 2022

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We aimed to delineate cardiopulmonary interactions in acute bronchiolitis and to evaluate the capacity of a combined cardiopulmonary ultrasonography to predict the need for respiratory support. This was a prospective observational single-center study that includes infants <12 month of age admitted to a hospital due to acute bronchiolitis. All the included patients underwent clinical, laboratory and cardiopulmonary ultrasonographic evaluation at the same time point within 24 h of hospital admission. The existence of significant correlation between cardiac and respiratory parameters was the primary outcome. The association of different cardiopulmonary variables with the need of respiratory support higher than O2, the length of stay hospitalization, the PICU stay and the duration of respiratory support were a secondary outcome. We enrolled 112 infants (median age 1 (0.5–3) months; 62% males) hospitalized with acute bronchiolitis. Increased values of the pulmonary variables (BROSJOD score, pCO2 and LUS) showed moderate correlations with NT-proBNP and all echocardiographic parameters indicative of pulmonary hypertension and myocardial dysfunction (Tei index). Up to 36 (32%) infants required respiratory support during the hospitalization. This group presented with higher lung ultrasound score (p < 0.001) and increased values of NT-proBNP (p < 0.001), the Tei index (p < 0.001) and pulmonary artery pressures (p < 0.001). All the analyzed respiratory and cardiac variables showed moderate-to-strong correlations with the LOS of hospitalization and the time of respiratory support. Lung ultrasound and echocardiography showed a moderate-to-strong predictive accuracy for the need of respiratory support in the ROC analysis, with the AUC varying from 0.74 to 0.87. Those cases of bronchiolitis with a worse pulmonary status presented with a more impaired cardiac status. Cardiopulmonary ultrasonography could be a useful tool to easily identify high-risk populations for complicated acute bronchiolitis hospitalization.

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Section: Discussionmentioning

confidence: 99%

Characterization of Cardiopulmonary Interactions and Exploring Their Prognostic Value in Acute Bronchiolitis: A Prospective Cardiopulmonary Ultrasound Study

et al. 2022

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“…Symptoms of cardiac failure, for example, tachypnea, tachycardia, prolonged capillary refill time, and mottling of the skin, may be difficult to distinguish from the symptoms of RSV bronchiolitis itself. 8 Thus, Caplow et al 8 suggested that CO as a measure of cardiac function should be assessed in hospitalized infants with RSV infection. The aim of this study was to investigate a predefined set of echocardiographic functional parameters, including right and left ventricular output, in relation to s-troponin, the need for supplementary oxygen or noninvasive respiratory support, and capillary refill time in children with RSV infection admitted to a regular pediatric ward.…”

Section: Introductionmentioning

confidence: 99%

Right and left ventricular function in hospitalized children with respiratory syncytial virus infection

Horter

Nakstad

Ashtari

et al. 2017

IDR

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BackgroundExtrapulmonary manifestations including cardiac dysfunction have been demonstrated in children with respiratory syncytial virus (RSV) infection requiring intensive care. The aim of this study was to examine cardiac function in hospitalized children with moderate RSV infection admitted to a regular pediatric ward.MethodsWe used echocardiography to determine cardiac output, and right and left ventricular function in 26 patients (aged 2 weeks to 24 months) with RSV infection. The echocardiographic results were compared with s-troponin, the need for supplementary oxygen or noninvasive respiratory support, and capillary refill time.ResultsThe number of measured s-troponins (ten [38%] of the included children) was too low to assess differences between children with elevated levels and those with normal levels. There were no differences in cardiac function between patients receiving oxygen treatment or respiratory support and those who did not. Capillary refill time did not correlate with any of the echocardiographic parameters. Both left and right ventricular output (mL/kg/min) was higher than published reference values. All other echocardiographic parameters were within the reference range.ConclusionChildren with moderate RSV infection had an increased left and right ventricular output, and cardiac function was well maintained. We conclude that routine cardiac ultrasound is not warranted in children with moderate RSV infection. The role of an elevated s-troponin in these patients remains to be determined.

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“…This device estimates CO, CI, stroke volume (SV), SI, and a variety of other cardiac parameters using a complex mathematical algorithm (electrical velocimetry relates the maximum rate of change of impedance to peak aortic blood acceleration during the cardiac cycle) with the simple application of four EKG electrodes . The accuracy of this monitor has been validated and compared with other measures of CO such as the Fick equation , thermodilution , and echocardiography in diverse pediatric populations including patients with congenital heart disease and critical illness , neonates , and obese adolescents . One study of patients who had recovered from critical illness demonstrated a bias toward underestimation of CI and another found it to be useful in patients who had undergone cardiac surgery .…”

Section: Discussionmentioning

confidence: 99%

Continuous noninvasive cardiac output in children: is this the next generation of operating room monitors? Initial experience in 402 pediatric patients

Coté

Sui

Anderson

et al. 2014

Pediatric Anesthesia

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Summary Background Electrical Cardiometry™ (EC) estimates cardiac parameters by measuring changes in thoracic electrical bioimpedance during the cardiac cycle. The ICON®, using four electrocardiogram electrodes (EKG), estimates the maximum rate of change of impedance to peak aortic blood acceleration (based on the premise that red blood cells change from random orientation during diastole (high impedance) to an aligned state during systole (low impedance)). Objective To determine whether continuous cardiac output (CO) data provide additional information to current anesthesia monitors that is useful to practitioners. Methods After IRB approval and verbal consent, 402 children were enrolled. Data were uploaded to our anesthesia record at one‐minute intervals. Ten‐second measurements (averaged over the previous 20 heart beats) were downloaded to separate files for later comparison with routine OR monitors. Results Data from 374 were in the final cohort (loss of signal or improper lead placement); 292 012 measurements during 58 049 min of anesthesia were made in these children (1 day to 19 years and 1 to 107 kg). Four events had a ≥25% reduction in cardiac index at least 1 min before a clinically important change in other monitored parameters; 18 events in 14 children confirmed manifestations of other hemodynamic measures; eight events may have represented artifacts because the observed measurements did not seem to fit the clinical parameters of the other monitors; three other events documented decreased stroke index with extreme tachycardia. Conclusions Electrical cardiometry provides real‐time cardiovascular information regarding developing hemodynamic events and successfully tracked the rapid response to interventions in children of all sizes. Intervention decisions must be based on the combined data from all monitors and the clinical situation. Our experience suggests that this type of monitor may be an important addition to real‐time hemodynamic monitoring.

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Changes in cardiac output and stroke volume as measured by non-invasive CO monitoring in infants with RSV bronchiolitis

Abstract: ∆CO was related to ΔSV and not Δ HR. The ∆CO and ΔSV were affected by fluid boluses. ΔRR correlated with ΔCO. Non-invasive CO monitoring can trend CO and SV in infants with bronchiolitis during hospitalization.

Cited by 11 publications

References 38 publications

Characterization of Cardiopulmonary Interactions and Exploring Their Prognostic Value in Acute Bronchiolitis: A Prospective Cardiopulmonary Ultrasound Study

Characterization of Cardiopulmonary Interactions and Exploring Their Prognostic Value in Acute Bronchiolitis: A Prospective Cardiopulmonary Ultrasound Study

Right and left ventricular function in hospitalized children with respiratory syncytial virus infection

Continuous noninvasive cardiac output in children: is this the next generation of operating room monitors? Initial experience in 402 pediatric patients

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