Rj. Peterson et al., TRANSTRACHEAL DOPPLER IN INFANTS AND SMALL CHILDREN FOLLOWING SURGERYFOR CONGENITAL HEART-DISEASE - RATIONAL USE OF AN IMPROVED TECHNOLOGY, Critical care medicine, 22(8), 1994, pp. 1294-1300
Objective: To compare measurements of cardiac output utilizing an impr
oved transtracheal Doppler technology with measurements obtained using
two-dimensional echocardiography. Design: Prospective, descriptive st
udy. Setting: Cardiovascular intensive care unit at a university medic
al center. Patients: Fourteen children ranging in age from 14 days to
3 yrs (mean 1.3 +/- .97 yrs) following surgery for complex congenital
heart disease. Interventions: Simultaneous cardiac output determinatio
ns using transtracheal Doppler and two-dimensional echocardiography we
re compared. Cardiac output was determined using measurement of blood
velocity and diameter of the ascending aorta following surgery. Direct
aortic diameter measurements made at operation were compared with mea
surements obtained by transtracheal Doppler, two-dimensional echocardi
ography and angiography. Results: The mean difference in aortic root d
iameter between measurements made directly at operation and transtrach
eal Doppler was 5%, compared with 13% by two-dimensional echocardiogra
phy, and 21% by angiography, a significant difference by analysis of v
ariance (F[3,31],p < .007). Post hoc comparisons demonstrated signific
ant (p < .05) differences between echocardiography and angiographic ao
rtic diameters. The mean difference between transtracheal Doppler and
echocardiographic determination of cardiac output was 10.9% (t[10] = -
1.37, p = .007). Conclusions: An improved transtracheal Doppler techno
logy compares favorably with echocardiographic determination of cardia
c output in infants and young children. This improved technology may p
rovide a useful means to assess cardiac output and may allow titration
of therapy in critically ill infants and children.