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Cardiac output monitoring in paediatric cardiac surgery: a review

Part of: Surgery

Published online by Cambridge University Press:  05 January 2021

Hannah M. Woodman ,
Corlyn Lee ,
Ayesha N. Ahmed ,
Bassit A. Malik ,
Sophie Mellor Open the ORCID record for Sophie Mellor [Opens in a new window] ,
Louise J. Brown Open the ORCID record for Louise J. Brown [Opens in a new window] ,
Leanne Gentle  and
Amer Harky Open the ORCID record for Amer Harky [Opens in a new window]
Hannah M. Woodman
Affiliation:
Medical School, College of Medical and Dental Sciences, University of Birmingham, Birmingham, UK
Corlyn Lee
Affiliation:
Medical School, College of Medical and Dental Sciences, University of Birmingham, Birmingham, UK
Ayesha N. Ahmed
Affiliation:
Medical School, College of Medical and Dental Sciences, University of Birmingham, Birmingham, UK
Bassit A. Malik
Affiliation:
Faculty of Public Health and Policy, London School of Hygiene & Tropical Medicine, London, UK
Sophie Mellor
Affiliation:
Medical School, College of Medical and Dental Sciences, University of Birmingham, Birmingham, UK
Louise J. Brown
Affiliation:
Medical School, College of Medical and Dental Sciences, University of Birmingham, Birmingham, UK
Leanne Gentle
Affiliation:
Department of Paediatric Intensive Care, Alder Hey Children Hospital, Liverpool, UK
Amer Harky*
Affiliation:
Department of Cardiothoracic Surgery, Liverpool Heart and Chest, Liverpool, UK Faculty of Life Sciences, University of Liverpool, Liverpool, UK Department of Congenital Cardiac Surgery, Alder Hey Children Hospital, Liverpool, UK
*
Author for correspondence: Amer Harky, MRCS, MSc, Department of Congenital Cardiac Surgery, Alder Hey Children Hospital, E Prescot Rd, LiverpoolL14 5AB, UK. Tel: +44-0151-228-4811. E-mail: aaharky@gmail.com
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Abstract

The aim of this review is to present the current options for cardiac output (CO) monitoring in children undergoing cardiac surgery. Current technologies for monitoring identified were a range of invasive, minimally invasive, and non-invasive technologies. These include pulmonary artery catheter, transoesophageal echocardiography, pulse contour analysis, electrical cardiography, and thoracic bioreactance. A literature search was conducted using evidence databases which identified two current guidelines; the NHS Greater Glasgow and Clyde guideline and Royal College of Anaesthetics Guideline. These were appraised using the AGREE II tool and the evidence identified was used to create an overview summary of each technological option for CO monitoring. There is limited evidence regarding the accuracy of modalities available for CO monitoring in paediatric patients during cardiac surgery. Each technology has advantages and disadvantages; however, none could be championed as the most beneficial. Furthermore, a gold standard for CO monitoring has not yet been identified for paediatric populations, nor is it apparent whether one modality is preferable based on the available evidence. Additional evidence using a standardised method for comparing CO measurements should be conducted in order to determine the best option for CO monitoring in paediatrics. Furthermore, cost-effectiveness assessment of each modality should be conducted. Only then will it be possible for clear, evidence-based guidance to be written.

Keywords

Paediatricpulmonary artery cathetertransoesophageal echocardiographypulse contour analysiselectrical cardiometrythoracic bioreactance
Type
Review
Information
Cardiology in the Young , Volume 31 , Issue 1 , January 2021 , pp. 23 - 30
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Copyright
© The Author(s), 2021. Published by Cambridge University Press

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Footnotes

Hannah M. Woodman and Corlyn Lee contributed equally to this article.

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