Anesthesia, Cardiac Output, Infant ALL
Conditions
Keywords
hemodynamics, electrical cariometry, non-invasive, infant
Brief summary
This study investigates the level of agreement of two non-invasive cardiac output monitors (transthoracic echocardiography and electrical cardiometry) in young children under anesthesia.
Detailed description
Young children are particularly prone to hemodynamic instability during the perioperative period which, in turn, may lead to organ morbidity. Currently, in routine surgical procedures in otherwise healthy children, hemodynamic status in the perioperative period is primarily assessed by non-invasive systemic blood pressure management. While this approach can detect systemic arterial hypotension, it does not provide us with guidance on whether the decrease in blood pressure is the result of changes in cardiac output and/or in systemic vascular resistance. This information would be important to know since treatment modalities may differ. Recent technical development in electrical cardiometry allows us to non-invasively monitor cardiac output. The accuracy of the method has been validated in neonatal and paediatric cohorts, and electrical cardiometry is now regularly used to monitor cardiac output in the perioperative setting. Nevertheless, the trending patterns of cardiac output in otherwise healthy young children undergoing routine surgical procedures, still need to be described. Due to technical aspects, transthoracic echocardiography is now recognised as gold-standard measurement of cardiac output in paediatric patients. This study is based on a commonly and non-invasively applied monitoring equipment (ICON) which is now regularly used on anesthetized children for the detection of cardiac output during the perioperative period. The primary objective of this validation study is to confirm the non-inferiority of cardiac output measurement with electrical cardiometry versus transthoracic echocardiography in young children ( 0-17 months of age) during the perioperative period. The secondary objective is to describe the trending aspects of cardiac output during the anaesthesia until the recovery.
Interventions
DIAGNOSTIC_TESTcardiac output monitoring with electrical cardiometry
comparison of limits of agreement between the two monitoring modalities
Sponsors
Laszlo Vutskits
Study design
Observational model
COHORT
Time perspective
PROSPECTIVE
Eligibility
Sex/Gender
ALL
Age
0 Months to 17 Months
Inclusion criteria
1. Age 0 to 17 months included 2. Greater than 36 weeks post-menstrual age (PMA) on the day of the study 3. Undergoing general anaesthesia for surgery that is expected to last more than 30 minutes (combines anaesthesia and surgical time) 4. Parental/guardian understands and reads French and permission (informed consent) obtained 5. ASA 1-3 status
Exclusion criteria
1. Structural/anatomical anomaly or other circumstances (e.g., patient positioning) making it difficult to apply the sensors to the body or limiting the feasibility of the TTE 2. Any Congenital heart diseases 3. Known allergy to electrodes' glue 4. Thoracic, cardiac and head surgery 5. Traumatic surgery with hemodynamic instability
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Cardiac output measured by transthoracic electocardiometry ICON®- expressed as L/minutes | During the intraoperative period, up to 30 minutes after anesthesia induction | This parameter is widely used in validation studies aimed to assess cardiac output |
| Cardiac output measured by Transthoracic echocardiography - expressed as L/minutes | During the intraoperative period, up to 30 minutes after anesthesia induction | This parameter is widely used in validation studies aimed to assess cardiac output |
| Estimation of bias between cardiac outputs measured by ICON and Transthoracic echocardiography | During the intraoperative period, up to 30 minutes after anesthesia induction | This statistical description is widely used in studies comparing accuracy/agreement between two different measurement modalities using the same units of measurements; it does not have a physical unit of measure |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| The secondary endpoints are the bias in the temporal trend of changes between ICON®- and TTE-derived cardiac index values, and the Mean Percentage Error (MPE). | During the intraoperative period, up to 30 minutes after anesthesia induction | These are statistical parameters and they do not have a physical unit of measure |
Countries
Switzerland
Contacts
Primary ContactLaszlo Vutskits, MD PhD
Outcome results
None listed