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Does obesity affect the non-invasive measurement of cardiac output performed by electrical cardiometry in children and adolescents?

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Abstract

Electrical cardiometry (EC) is a non-invasive and inexpensive method for hemodynamic assessment and monitoring. However, its feasibility for widespread clinical use, especially for the obese population, has yet to be determined. In this study, we evaluated the agreement and reliability of EC compared to transthoracic Doppler echocardiography (TTE) in normal, overweight, and obese children and adolescents. We measured stroke volume (SV) and cardiac output (CO) of 131 participants using EC and TTE simultaneously. We further divided these participants according to BMI percentiles for subanalyses: <85% normal weight (n = 41), between 85 and 95% overweight (n = 7), and >95% obese (n = 83). Due to small sample size of the overweight group, we combined overweight and obese groups (OW+OB) with no significant change in results (SV and CO) before and after combining groups. There were strong correlations between EC and TTE measurements of SV (r = 0.869 and r = 0.846; p < 0.0001) and CO (r = 0.831 and r = 0.815; p < 0.0001) in normal and OW+OB groups, respectively. Bias and percentage error for CO measurements were 0.240 and 29.7%, and 0.042 and 29.5% in the normal and OW+OB groups, respectively. Indexed values for SV were lower in the OW+OB group than in the normal weight group when measured by EC (p < 0.0001) but no differences were seen when measured by TTE (p = 0.096). In all weight groups, there were strong correlations and good agreement between EC and TTE. However, EC may underestimate hemodynamic measurements in obese participants due to fat tissue.

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Acknowledgements

We would like to thank Elizabeth Burrill (NP) and Jody Jones (RDMS) for their support recruiting patients and performing echocardiography; and Adam A. Dempsey for his assistance with manuscript revisions.

Funding

This study was partially supported by research grants from Western University (ADF-5609-8), Children’s Health Research Institute (LHRF 7712), Innovation Fund of the Alternative Funding Plan of the Academic Health Sciences Centres of Ontario (AMOSO, #INN 12-003) and grant from Children’s Health Foundation, London, Ontario to Dr. K. Norozi.

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Authors and Affiliations

  1. Division of Paediatric Cardiology, Department of Paediatrics, Western University, 800 Commissioners Rd E, PO Box 5010, London, N6A 5W9s, Canada

    Luis Altamirano-Diaz, Eva Welisch, Michael Miller & Kambiz Norozi

  2. Children’s Health Research Institute, London, Canada

    Luis Altamirano-Diaz, Eva Welisch, Michael Miller & Kambiz Norozi

  3. Paediatric Cardiopulmonary research laboratory, London Health science centre, London, Canada

    Luis Altamirano-Diaz, Eva Welisch, Teresa Sohee Park & Kambiz Norozi

  4. Department of Paediatrics, Rems-Murr Hospital, Winnenden, Germany

    Ralf Rauch

  5. Department of Paediatric Cardiology and Intensive Care Medicine, Medical School Hannover, Hannover, Germany

    Kambiz Norozi

  6. Department of Paediatric Cardiology and Intensive Care Medicine, University of Goettingen, Goettingen, Germany

    Kambiz Norozi

Authors
  1. Luis Altamirano-Diaz
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  2. Eva Welisch
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  3. Ralf Rauch
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  4. Michael Miller
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  5. Teresa Sohee Park
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  6. Kambiz Norozi
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Correspondence to Kambiz Norozi.

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The authors declare that they have no conflict of interest.

Ethical approval

This study was approved by the Western University Health Science Research Ethics Board (REB # 16266E). All children and adolescents gave written consent to participate in this study. For those under 16 years of age, we obtained written consent from caregivers.

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Altamirano-Diaz, L., Welisch, E., Rauch, R. et al. Does obesity affect the non-invasive measurement of cardiac output performed by electrical cardiometry in children and adolescents?. J Clin Monit Comput 32, 45–52 (2018). https://doi.org/10.1007/s10877-017-9994-1

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  • DOI: https://doi.org/10.1007/s10877-017-9994-1

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