Measurement of Cardiac Output in Children

  • I. A. Murdoch
  • M. J. Marsh
  • G. Morrison
Part of the Yearbook of Intensive Care and Emergency Medicine book series (YEARBOOK, volume 1995)


Measurement and manipulation of cardiac output (CO), arterial oxygen delivery (cardiac index x arterial oxygen content) and oxygen consumption (cardiac index x arterio-venous oxygen content difference) has become routine in the ICU adult practice. The practicalities involved, however, make the same techniques difficult if not impossible to employ in children and infants. Furthermore, considerable doubt now surrounds the concept of ‘delivery-dependent oxygen consumption’ and whether or not ‘goal directed therapy’ as proposed by Shoemaker is appropriate in any critically ill adult or pediatric patient [1].


Cardiac Output Doppler Probe Aortic Blood Flow Thermodilution Technique Systemic Blood Flow 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.


Unable to display preview. Download preview PDF.

Unable to display preview. Download preview PDF.


  1. 1.
    Hayes MA, Timmins AC, Yau EHS, Palazzo M, Hinds CJ, Watson D (1994) Elevation of systemic oxygen delivery in the treatment of critically ill patients. N Engl J Med 330: 1717–1722PubMedCrossRefGoogle Scholar
  2. 2.
    Pollack MM, Fields AI, Ruttimann UE (1985) Distribution of cardiopulmonary variables in pediatric survivors and nonsurvivors off septic shock. Crit Care Med 13: 454–459PubMedCrossRefGoogle Scholar
  3. 3.
    Fegler G (1954) Measurement of cardiac output in anaesthetized animals by a thermodilution method. Quart J Exp Physiol 39: 153–164PubMedGoogle Scholar
  4. 4.
    Branthwaite MA, Bradley RD (1968) Measurement of cardiac output by thermal dilution in man. J Appl Physiol 24: 434–438PubMedGoogle Scholar
  5. 5.
    Swan HCJ, Ganz W, Forrester JMH, Diamond G, Chonette D (1970) Catheterization of the heart in human with the use of a flow-directed balloon-tipped catheter. N Engl J Med 283: 447–451PubMedCrossRefGoogle Scholar
  6. 6.
    Silove ED, Tynan MJ, Simcha AJ (1972) Thermal dilution measurement of pulmonary and systemic blood flow in secundum atrial septal defect, and transposition of the great arteries with intact interventricular septum. Br Heart J 34: 1142–1146PubMedCrossRefGoogle Scholar
  7. 7.
    Freed MD, Keene JF (1978) Cardiac output measured by thermodilution in infants and children. J Pediatr 92: 39–42PubMedCrossRefGoogle Scholar
  8. 8.
    Salgado CR, Galletti PM (1966) In vitro evaluation of the thermodilution technique for the measurement of ventricular stroke volume and end-diastolic volume. Cardiologia 49: 65–78PubMedCrossRefGoogle Scholar
  9. 9.
    Van Grondelle A, Ditchey RV, Groves BM, Wagner WW Jr, Reeves JT (1983) Thermodilution method overestimates low cardiac output in humans. Am J Physiol 245: H690–H692PubMedGoogle Scholar
  10. 10.
    Levett JM, Repogle RL (1979) Thermodilution cardiac output: A critical analysis and review of the literature. J Surg Res 27: 392–404PubMedCrossRefGoogle Scholar
  11. 11.
    Jansen JRC, Schreuder JJ, Settels JJ, Kloek JJ, Versprille A (1990) An adequate strategy for the thermodilution technique in patients during mechanical ventilation. Intensive Care Med 16: 422–425PubMedCrossRefGoogle Scholar
  12. 12.
    Enghoff E, Sjorgen S (1973) Thermal dilution for measurement of cardiac output in the pulmonary artery in man in relation to choice of indicator volume and injection time. Ups J Med Sci 78: 33–37PubMedCrossRefGoogle Scholar
  13. 13.
    Harris AP, Miller CF, Beattie C, Rosenfeld G, Rogers M (1985) The slowing of the sinus rhythm during thermodilution cardiac output determination and the effect of altering the injectate temperature. Anesthesiology 63: 540–541PubMedCrossRefGoogle Scholar
  14. 14.
    Damen J, Weaver JEAT (1987) The use of balloon-tipped pulmonary artery catheters in children undergoing cardiac surgery. Intensive Care Med 13: 266–272PubMedCrossRefGoogle Scholar
  15. 15.
    Bock JC, Barker BC, Mackersie RC, Trannbaugh RF, Lewis FR (1989) Cardiac output measurement using femoral arterial thermodilution in patients. J Crit Care 3: 106–111Google Scholar
  16. 16.
    Tibballs J, Osbourne A, Hockmann M (1988) A comparative study of cardiac output measurement by dye dilution and pulsed Doppler ultrasound. Anaesth Intensive Care 16: 272–277Google Scholar
  17. 17.
    Hillis LD, Firth BG, Winniford MD (1985) Analysis of factors affecting the variability of Fick versus indicator dilution measurements of cardiac output. Am J Cardiol 56: 764–768PubMedCrossRefGoogle Scholar
  18. 18.
    Fanconi S, Burger R (1992) Measurement of cardiac output in children. Intensive Care World 9: 8–12Google Scholar
  19. 19.
    Takala J, Keinanen O, Vaisanen P, Kari A (1989) Measurement of gas exchange in intensive care: Laboratory and clinical validation of a new device. Intensive Care Med 17: 1041–1047Google Scholar
  20. 20.
    Chang AC, Kulik TJ, Hickey PR, Wessel DL (1993) Real-time gas-exchange measurement of oxygen consumption in neonates and infants after cardiac surgery. Crit Care Med 21: 1369–1375PubMedCrossRefGoogle Scholar
  21. 21.
    Kubicek WG, Karnegis JN, Patterson RP (1966) Development and evaluation of an impedance cardiac output system. Aerospace Med 37: 1208–1212PubMedGoogle Scholar
  22. 22.
    Tibballs J (1989) A comparative study of cardiac output in neonates supported by mechanical ventilation: Measurement with thoracic electrical bioimpedance and pulsed Doppler. J Pediatr 114: 632–635PubMedCrossRefGoogle Scholar
  23. 23.
    Introna RPS, Preutt JK, Crumrine RC, Cuadrado AR (1988) Use of transthoracic bioimpedance to determine cardiac output in pediatric patients. Crit Care Med 16: 1101–1105PubMedCrossRefGoogle Scholar
  24. 24.
    Clarke DE, Raffin TA (1993) Thoracic electrical bioimpedance measurement of cardiac output — Not ready for prime time. Crit Care Med 21: 1111–1112PubMedCrossRefGoogle Scholar
  25. 25.
    Morrow WR, Murphy DJ, Fisher DJ, Huhta JC, Jefferson LS, Smith E (1988) Continuous wave doppler cardiac output: Use in pediatric patients receiving inotropic support. Pediatr Cardiol 9: 131–136PubMedCrossRefGoogle Scholar
  26. 26.
    Greenfield JC, Patel DJ (1962) Relationship between pressure and diameter in the ascending aorta in man. Circ Res 10: 778–781PubMedGoogle Scholar
  27. 27.
    Dobb GJ, Donovan KD (1987) Non-invasive methods of measuring cardiac output. Intensive Care Med 13: 304–309PubMedGoogle Scholar
  28. 28.
    Mellander M, Sabel KG, Caidahl K, Solymar L, Eriksson B (1987) Doppler determination of cardiac output in infants and children: Comparison with simultaneous thermodilution. Pediatr Cardiol 8: 241–246PubMedCrossRefGoogle Scholar
  29. 29.
    Hudson I, Houston I, Aitchison T, Holland B, Turner T (1990) Reproducibility of measurements of cardiac output in newborn infants by Doppler ultrasound. Arch Dis Child 65: 15–19PubMedCrossRefGoogle Scholar
  30. 30.
    Abrahms JH, Weber RE, Holmen KD (1989) Continuous cardiac determination using the Transtracheal Doppler: Initial results in humans. Anesthesiology 71: 11–15CrossRefGoogle Scholar
  31. 31.
    Markovitz BP, Zimmerman A, Spray T (1992) Transtracheal Doppler cardiac output in pediatric patients: Comparison with the Fick principle. Crit Care Med 20: S15 (Abst)Google Scholar
  32. 32.
    Armstrong PJ, Sinclair CJ, Campanella C (1993) The transtracheal Doppler probe. Br J Intensive Care 3: 175–182Google Scholar
  33. 33.
    Side CD, Gosling RJ (1971) Non-surgical assessment of cardiac function. Nature 232: 335–336PubMedCrossRefGoogle Scholar
  34. 34.
    Fisher DC, Sahn DU, Friedman MJ, et al (1983) The variations of pulsed Doppler sampling site on calculation of cardiac output: An experimental study in open chest dogs. Circulation 67: 370–376PubMedCrossRefGoogle Scholar
  35. 35.
    Diagle RE, Miller CW, Histand MB, McLeon FD, Hokanson DE (1975) Non-traumatic aortic blood flow sensing by use of an ultrasonic esophageal probe. J Appl Physiol 38: 1153–1160Google Scholar
  36. 36.
    Singer M, Clarke J, Bennett D (1989) Continuous hemodynamic monitoring by esophageal Doppler. Crit Care Med 17: 447–452PubMedCrossRefGoogle Scholar
  37. 37.
    Murdoch IA, Marsh MJ, Tibby SM, McLuckie A (1995) Continuous haemodynamic monitoring in children: The use of Transoesophageal Doppler. Acta Paediatr (In Press)Google Scholar
  38. 38.
    Wade OL, Bishop JM (1962) Distribution of the cardiac output in normal subjects at rest: In: Wade OL, bishop JM (ed). Cardiac output and regional blood flow. Blackwell Scientific Publications, Oxford pp 86–94Google Scholar

Copyright information

© Springer-Verlag Berlin Heidelberg 1995

Authors and Affiliations

  • I. A. Murdoch
  • M. J. Marsh
  • G. Morrison

There are no affiliations available

Personalised recommendations