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Noninvasive Transcutaneous Doppler Ultrasound-Derived Hemodynamic Reference Ranges in Chinese Adolescents.
MedLine Citation:
PMID:  23439468     Owner:  NLM     Status:  Publisher    
Abstract/OtherAbstract:
OBJECTIVES:: The ultrasonic cardiac output monitor is a noninvasive, quantitative method for measuring and monitoring cardiovascular hemodynamic parameters in patients. The aims of this study were first to establish reference ranges for cardiovascular indices measured by the ultrasonic cardiac output monitor in Chinese children aged 12-18 yr, second to assess the interobserver reliability of the method, and third to compare these ranges with a Caucasian group from Australia. DESIGN, SETTING, AND SUBJECTS:: This was a population-based cross-sectional cohort study of Chinese adolescents aged 12-18 yr, performed in secondary schools in Hong Kong. INTERVENTIONS:: Ultrasonic cardiac output monitor scans were performed on each subject to measure stroke volume, cardiac output, and systemic vascular resistance together with standard oscillometric measurement of blood pressure and heart rate. Ultrasonic cardiac output monitor parameters were also standardized by deriving body surface area referenced indices. Normal ranges were defined as lying within two standard deviations on either side of the mean. To assess interobserver variability, a second, blinded operator repeated 17% of scans. MEASUREMENTS AND MAIN RESULTS:: A total of 590 Chinese adolescents (49% boys) were scanned. Normal ranges for cardiac output, cardiac index, stroke volume, stroke volume index, stroke volume resistance, and systemic vascular resistance index are presented. Males had a significantly higher mean stroke volume, cardiac output, and systemic vascular resistance index compared with females (p < 0.05), but no significant differences were found for the indexed values. When compared with a group of 31 Australian Caucasian adolescents (71% boys), Chinese adolescents have a significantly lower cardiac output and stroke volume (p < 0.05), but these differences disappeared when adjusted for body surface area (i.e., stroke volume index, cardiac index, and systemic vascular resistance index). Interobserver variability of ultrasonic cardiac output monitor-derived stroke volume showed a coefficient of variation of 10.2%, a correlation coefficient of 0.90 (95% confidence interval 0.85-0.93), while Bland-Altman analysis showed a mean bias of 1.5% (95% limits of agreement were -19.9% to 23.0%). CONCLUSIONS:: This study presents normal values for cardiovascular indices in Chinese adolescents using the ultrasonic cardiac output monitor. When referenced to body surface area, the differences between Caucasians and Chinese were insignificant.
Authors:
Grace Y L Ho; Giles N Cattermole; Stewart S W Chan; Brendan E Smith; Colin A Graham; Timothy H Rainer
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Publication Detail:
Type:  JOURNAL ARTICLE     Date:  2013-2-22
Journal Detail:
Title:  Pediatric critical care medicine : a journal of the Society of Critical Care Medicine and the World Federation of Pediatric Intensive and Critical Care Societies     Volume:  -     ISSN:  1529-7535     ISO Abbreviation:  Pediatr Crit Care Med     Publication Date:  2013 Feb 
Date Detail:
Created Date:  2013-2-26     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  100954653     Medline TA:  Pediatr Crit Care Med     Country:  -    
Other Details:
Languages:  ENG     Pagination:  -     Citation Subset:  -    
Affiliation:
1 Accident and Emergency Medicine Academic Unit, Chinese University of Hong Kong, Hong Kong, China. 2 Faculty of Medicine, University of Melbourne, Melbourne, Australia. 3 Emergency Department, Princess Royal University Hospital, London, UK. 4 School of Biomedical Science, Charles Sturt University, Bathurst, New South Wales, Australia. 5 Intensive Care Unit, Bathurst Base Hospital, Bathurst, New South Wales, Australia.
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