Accuracy and repeatability of pediatric cardiac output measurement using Doppler: 20-Year review of the literature
Abstract
Objective Review of the accuracy and repeatability of Doppler cardiac output (CO) measurements in children.Design Publications in the scientific literature retrieved using a computerized Medline search from 1982-2002 and a manual review of article bibliographies. Studies comparing Doppler flow measurements with thermodilution, Fick, or dye dilution methods in the pediatric critical care setting were identified to assess the bias, precision, and intra- and interobserver repeatability of Doppler CO measurement. Where results were not suitable for comparison and the original measurements available, data were re-analyzed using appropriate statistical methods and presented in comparative tables.Results The precision of pediatric Doppler CO measurements compared to thermodilution, dye dilution, or Fick methods is around 30% and repeatability varies from less than 1% to 22%. Bias is generally less than 10% but varies considerably.Conclusions The bias, precision, and repeatability from study to study indicate that Doppler CO measurements are acceptably reproducible in children, with best results when used to track changes rather than absolute values, and using the transesophageal approach.
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Despite its known limitations, including relatively high intra- and interobserver variability (coefficient of variation ranging from 2.1% to 22% and 3.1% to 22%, respectively), echocardiography remains the most widely adopted modality in neonatal and pediatric intensive care.
“Despite its known limitations, including relatively high intra- and interobserver variability (coefficient of variation ranging from 2.1% to 22% and 3.1% to 22%, respectively) [58], echocardiography remains the most widely adopted modality in neonatal and pediatric intensive care.”
From Trends and Challenges in Noninvasive Hemodynamic Monitoring of Neonates Following Cardiac Surgery: A Narrative Review (2025) · cites this paper as [58]
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“Despite its known limitations, including relatively high intra-and interobserver variability (coefficient of variation ranging from 2.1% to 22% and 3.1% to 22%, respectively) [58], echocardiography remains the most widely adopted modality in neonatal and pediatric intensive care.”
Influential
- Authors
- Chew, M. S., & Poelaert, J.
- Affiliations
- Skåne University Hospital (SE)
- Ghent University Hospital (BE)
- Corresponding author
- Chew, Michelle S.
- Venue
- Intensive Care Medicine
- Published
- 2003-11-01
- Volume
- 29
- Issue
- 11
- Pages
- 1889-1894
- ISSN
- 0342-4642 (ISSN-L)
- 1432-1238
- OpenAlex
- W2074626476
- Cited by
- 151
- References
- 32
- Citations by year
- 2026: 3 · 2025: 5 · 2024: 7 · 2023: 2 · 2022: 6 · 2021: 9 · 2020: 7 · 2019: 11 · 2018: 6 · 2017: 8 · 2016: 4 · 2015: 7 · 2014: 7 · 2013: 10 · 2012: 12
- FWCI
- 3.83
- Type
- journal article
- Language
- en
- Open access
- closed
- Licence
- www.springer.com/tdm (tdm)
- Locations
- Intensive Care Medicine (publishedVersion)
- PubMed (publishedVersion)
- Ghent University Academic Bibliography (Ghent University) (submittedVersion)
- Lund University Publications (Lund University) (submittedVersion)
- Topics
- Health Sciences › Medicine › Surgery › Hemodynamic Monitoring and Therapy
- Health Sciences › Medicine › Epidemiology › Sepsis Diagnosis and Treatment
- Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Cardiovascular Function and Risk Factors
- Keywords
- measurement accuracy, repeatability, thermodilution, Fick method, dye dilution, esophageal Doppler, pediatric intensive care, measurement bias
- MeSH terms
- Cardiac Output, Child, Critical Care, Data Interpretation, Statistical, Dye Dilution Technique, Humans, Monitoring, Physiologic, Research Design, Sensitivity and Specificity, Thermodilution, Echocardiography, Doppler, Reproducibility of Results, Bias, Echocardiography, Transesophageal
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