Effect of solute temperature in the measurement of cardiac output in children using the thermodilution technique

Shyam Sathanandam, Pooja Kashyap, David Zurakowski, Lindsey Bird, Vera McGhee, Jeffrey Towbin, Benjamin Rush Waller

Research output: Contribution to journalArticle

1 Citation (Scopus)

Abstract

Objectives: The primary aim of this study was to compare thermodilution (TD) cardiac index (TDCi) measured by injecting cold saline (C-TDCi) to saline at room temperature (R-TDCi). The secondary aim was to assess the change in body temperature with cold saline injections in children. Design: This is a prospective, case control study. Setting: Cardiac catheterization lab at Le Bonheur Children's Hospital, Memphis, Tennessee. Patients: Eighty-six children ≤18 years of age that underwent cardiac catheterization between April 2013 and April 2015, excluding patients with admixing lesions, on inotropic support and with ejection fraction < 30%. Interventions: A TD catheter in the main pulmonary artery was used to measure cardiac output (CO). Each patient received manual injections of saline at room temperature followed by cold saline to calculate the CO. Outcome Measures: CO by C-TDCi, R-TDCi, and Fick-Ci were compared using four different statistical methods. Results: R-TDCi and Fick-Ci had a strong linear correlation (rho = 0.91 and 0.77, respectively; P < 0.0001) to C-TDCi. R-TDCi and Fick-Ci also had high 1:1 intra-class correlation to C-TDCi (ICC-rho= 0.82 and 0.68, respectively; P < 0.01). 96% confidence limits by equivalence testing for R-TDCi and Fick-Ci were 0.98-1.02 and 0.96-1.05 respectively (P < 0.0001), when compared to C-TDCi. Mean difference (±SD) calculated by Bland-Altman analysis showed a higher score for R-TDCi (0.012 ± 0.32 L/min/m2) compared to Fick-Ci (0.2 ± 0.72 L/min/m2), but it was not statistically different (P = 0.25). In a subgroup analysis of children ≤2 years (n = 27), the results from all 3 techniques were equivalent. There was a 0.2 ± 0.16ºC drop in BT compared to a 0.08 ± 0.19ºC drop in those >2 years (P > 0.05). Conclusions: Cardiac indexes determined by Fick, C-TDCi, and R-TDCi were equivalent in children. Saline at room temperature can be used as an alternative to cold saline to avoid potential drop in body temperature of these patients.

Original languageEnglish (US)
Pages (from-to)181-187
Number of pages7
JournalCongenital Heart Disease
Volume12
Issue number2
DOIs
StatePublished - Mar 1 2017

Fingerprint

Thermodilution
Cardiac Output
Temperature
Cardiac Catheterization
Body Temperature Changes
Body Temperature
Case-Control Studies
Injections

All Science Journal Classification (ASJC) codes

  • Pediatrics, Perinatology, and Child Health
  • Surgery
  • Radiology Nuclear Medicine and imaging
  • Cardiology and Cardiovascular Medicine

Cite this

Effect of solute temperature in the measurement of cardiac output in children using the thermodilution technique. / Sathanandam, Shyam; Kashyap, Pooja; Zurakowski, David; Bird, Lindsey; McGhee, Vera; Towbin, Jeffrey; Rush Waller, Benjamin.

In: Congenital Heart Disease, Vol. 12, No. 2, 01.03.2017, p. 181-187.

Research output: Contribution to journalArticle

Sathanandam, Shyam ; Kashyap, Pooja ; Zurakowski, David ; Bird, Lindsey ; McGhee, Vera ; Towbin, Jeffrey ; Rush Waller, Benjamin. / Effect of solute temperature in the measurement of cardiac output in children using the thermodilution technique. In: Congenital Heart Disease. 2017 ; Vol. 12, No. 2. pp. 181-187.
@article{f5fc9a09369c4d488c13da3030bd9c99,
title = "Effect of solute temperature in the measurement of cardiac output in children using the thermodilution technique",
abstract = "Objectives: The primary aim of this study was to compare thermodilution (TD) cardiac index (TDCi) measured by injecting cold saline (C-TDCi) to saline at room temperature (R-TDCi). The secondary aim was to assess the change in body temperature with cold saline injections in children. Design: This is a prospective, case control study. Setting: Cardiac catheterization lab at Le Bonheur Children's Hospital, Memphis, Tennessee. Patients: Eighty-six children ≤18 years of age that underwent cardiac catheterization between April 2013 and April 2015, excluding patients with admixing lesions, on inotropic support and with ejection fraction < 30{\%}. Interventions: A TD catheter in the main pulmonary artery was used to measure cardiac output (CO). Each patient received manual injections of saline at room temperature followed by cold saline to calculate the CO. Outcome Measures: CO by C-TDCi, R-TDCi, and Fick-Ci were compared using four different statistical methods. Results: R-TDCi and Fick-Ci had a strong linear correlation (rho = 0.91 and 0.77, respectively; P < 0.0001) to C-TDCi. R-TDCi and Fick-Ci also had high 1:1 intra-class correlation to C-TDCi (ICC-rho= 0.82 and 0.68, respectively; P < 0.01). 96{\%} confidence limits by equivalence testing for R-TDCi and Fick-Ci were 0.98-1.02 and 0.96-1.05 respectively (P < 0.0001), when compared to C-TDCi. Mean difference (±SD) calculated by Bland-Altman analysis showed a higher score for R-TDCi (0.012 ± 0.32 L/min/m2) compared to Fick-Ci (0.2 ± 0.72 L/min/m2), but it was not statistically different (P = 0.25). In a subgroup analysis of children ≤2 years (n = 27), the results from all 3 techniques were equivalent. There was a 0.2 ± 0.16ºC drop in BT compared to a 0.08 ± 0.19ºC drop in those >2 years (P > 0.05). Conclusions: Cardiac indexes determined by Fick, C-TDCi, and R-TDCi were equivalent in children. Saline at room temperature can be used as an alternative to cold saline to avoid potential drop in body temperature of these patients.",
author = "Shyam Sathanandam and Pooja Kashyap and David Zurakowski and Lindsey Bird and Vera McGhee and Jeffrey Towbin and {Rush Waller}, Benjamin",
year = "2017",
month = "3",
day = "1",
doi = "10.1111/chd.12423",
language = "English (US)",
volume = "12",
pages = "181--187",
journal = "Congenital Heart Disease",
issn = "1747-079X",
publisher = "Wiley-Blackwell",
number = "2",

}

TY - JOUR

T1 - Effect of solute temperature in the measurement of cardiac output in children using the thermodilution technique

AU - Sathanandam, Shyam

AU - Kashyap, Pooja

AU - Zurakowski, David

AU - Bird, Lindsey

AU - McGhee, Vera

AU - Towbin, Jeffrey

AU - Rush Waller, Benjamin

PY - 2017/3/1

Y1 - 2017/3/1

N2 - Objectives: The primary aim of this study was to compare thermodilution (TD) cardiac index (TDCi) measured by injecting cold saline (C-TDCi) to saline at room temperature (R-TDCi). The secondary aim was to assess the change in body temperature with cold saline injections in children. Design: This is a prospective, case control study. Setting: Cardiac catheterization lab at Le Bonheur Children's Hospital, Memphis, Tennessee. Patients: Eighty-six children ≤18 years of age that underwent cardiac catheterization between April 2013 and April 2015, excluding patients with admixing lesions, on inotropic support and with ejection fraction < 30%. Interventions: A TD catheter in the main pulmonary artery was used to measure cardiac output (CO). Each patient received manual injections of saline at room temperature followed by cold saline to calculate the CO. Outcome Measures: CO by C-TDCi, R-TDCi, and Fick-Ci were compared using four different statistical methods. Results: R-TDCi and Fick-Ci had a strong linear correlation (rho = 0.91 and 0.77, respectively; P < 0.0001) to C-TDCi. R-TDCi and Fick-Ci also had high 1:1 intra-class correlation to C-TDCi (ICC-rho= 0.82 and 0.68, respectively; P < 0.01). 96% confidence limits by equivalence testing for R-TDCi and Fick-Ci were 0.98-1.02 and 0.96-1.05 respectively (P < 0.0001), when compared to C-TDCi. Mean difference (±SD) calculated by Bland-Altman analysis showed a higher score for R-TDCi (0.012 ± 0.32 L/min/m2) compared to Fick-Ci (0.2 ± 0.72 L/min/m2), but it was not statistically different (P = 0.25). In a subgroup analysis of children ≤2 years (n = 27), the results from all 3 techniques were equivalent. There was a 0.2 ± 0.16ºC drop in BT compared to a 0.08 ± 0.19ºC drop in those >2 years (P > 0.05). Conclusions: Cardiac indexes determined by Fick, C-TDCi, and R-TDCi were equivalent in children. Saline at room temperature can be used as an alternative to cold saline to avoid potential drop in body temperature of these patients.

AB - Objectives: The primary aim of this study was to compare thermodilution (TD) cardiac index (TDCi) measured by injecting cold saline (C-TDCi) to saline at room temperature (R-TDCi). The secondary aim was to assess the change in body temperature with cold saline injections in children. Design: This is a prospective, case control study. Setting: Cardiac catheterization lab at Le Bonheur Children's Hospital, Memphis, Tennessee. Patients: Eighty-six children ≤18 years of age that underwent cardiac catheterization between April 2013 and April 2015, excluding patients with admixing lesions, on inotropic support and with ejection fraction < 30%. Interventions: A TD catheter in the main pulmonary artery was used to measure cardiac output (CO). Each patient received manual injections of saline at room temperature followed by cold saline to calculate the CO. Outcome Measures: CO by C-TDCi, R-TDCi, and Fick-Ci were compared using four different statistical methods. Results: R-TDCi and Fick-Ci had a strong linear correlation (rho = 0.91 and 0.77, respectively; P < 0.0001) to C-TDCi. R-TDCi and Fick-Ci also had high 1:1 intra-class correlation to C-TDCi (ICC-rho= 0.82 and 0.68, respectively; P < 0.01). 96% confidence limits by equivalence testing for R-TDCi and Fick-Ci were 0.98-1.02 and 0.96-1.05 respectively (P < 0.0001), when compared to C-TDCi. Mean difference (±SD) calculated by Bland-Altman analysis showed a higher score for R-TDCi (0.012 ± 0.32 L/min/m2) compared to Fick-Ci (0.2 ± 0.72 L/min/m2), but it was not statistically different (P = 0.25). In a subgroup analysis of children ≤2 years (n = 27), the results from all 3 techniques were equivalent. There was a 0.2 ± 0.16ºC drop in BT compared to a 0.08 ± 0.19ºC drop in those >2 years (P > 0.05). Conclusions: Cardiac indexes determined by Fick, C-TDCi, and R-TDCi were equivalent in children. Saline at room temperature can be used as an alternative to cold saline to avoid potential drop in body temperature of these patients.

UR - http://www.scopus.com/inward/record.url?scp=84996561785&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=84996561785&partnerID=8YFLogxK

U2 - 10.1111/chd.12423

DO - 10.1111/chd.12423

M3 - Article

C2 - 27813342

AN - SCOPUS:84996561785

VL - 12

SP - 181

EP - 187

JO - Congenital Heart Disease

JF - Congenital Heart Disease

SN - 1747-079X

IS - 2

ER -