Cardiac output measurement using an ultrasound dilution method: A validation study in ventilated piglets

Objective: To assess agreement between a new method of cardiac. output monitoring, using ultrasound dilution technology and ultrasound transit time-based measurement of pulmonary blood flow in a piglet model. Design: Prospective, experimental juvenile animal study. Setting: Animal laboratory of a university hospital. Subjects: Nine random-bred piglets. Interventions: After the animals received general anesthesia, we placed intravascular arterial and central venous catheters with the tip positioned in the abdominal aorta and the right atrium, respectively. The catheters were connected to the ultrasound dilution cardiac output monitor. An ultrasound transit time perivascular flow probe was positioned around the common pulmonary artery and served as the standard reference measurement. Cardiac output was manipulated during the experiment by creating hemorrhagic hypotension. Ultrasound dilution cardiac output was measured intermittently with injection volumes of 0.5 mL/kg and 1.0 mL/kg of isotonic saline at body temperature. Measurements and Main Results: Ultrasound dilution cardiac Output (Q(UDCO)) measurement was compared with pulmonary blood flow (Q(APC)). Bias, defined as Q(UDCO) minus Q(APC) was calculated for each measurement. Mean bias with standard deviation was calculated for measurements with volumes of injected saline, 0.5 mL/kg and 1.0 mL/kg, and compared using the Mann-Whitney U test. Mean bias (SD) between Q(UDCO) and Q(APC) was 0.040 (0.132) and 0.058 (0.136) L/min for measurement with 0.5 mL/kg and 1.0 mL/kg of isotonic saline, respectively (no statistically significant difference). Conclusions: Ultrasound dilution cardiac output measurement is reliable in piglets with the use of a small volume of a nontoxic indicator (isotonic saline). (Pediatr Crit Care Med 2010; 11:103-108)