Cardiac index monitoring by femoral arterial thermodilution after cardiac surgery in children

Abstract

Purpose: The aim of this study is to determine whether the maintenance of cardiac index (CI) measured by femoral arterial thermodilution during the postoperative period after heart surgery in children is related to short-term outcome.

Materials and methods: A prospective observational study in a pediatric intensive care unit at a referral hospital for congenital heart disease was conducted. Thirty-five children after open heart surgery were monitored in 5 planned times with PiCCO (Pulsion Medical System AG, Munich, Germany) during the first 24 hours after admission. Normal CI was defined as 3 L min(-1) m(-2) or greater.

Results: Eighteen patients hold CI at every measurement point. In this group, the median stay in the pediatric intensive care unit was 3 days (range, 2-7 days) compared with the median of 6 days (range, 2-34 days) obtained by the rest (P<.005). Duration of mechanical ventilation was 12 hours (range, 3-48 hours), and overall stay in the hospital was 6 days (range, 2-15 days) compared with 25 hours (range 6-432 hours) and 16 days (range, 4-50 days) obtained by the second group (P<.05). No complications were attributed to the use of the device.

Conclusions: Monitoring by femoral arterial thermodilution has been feasible in our experience. Maintenance of a CI of 3 L min(-1) m(-2) or greater is related to a better patient's early outcome.

Keywords: Cardiac index; Femoral arterial thermodilution; Hemodynamic monitoring; Pediatric cardiac surgery.