Electrical Cardiometry: A Reliable Solution to Cardiac Output Estimation in Children With Structural Heart Disease
Abstract
Objective Comparison of cardiac output (CO) obtained using electric cardiometry (EC) and pulmonary artery catheterization (PAC) in pediatric patients with congenital structural heart disease.Design Prospective, observational study.Setting A tertiary hospital.Participants The study comprised 50 patients scheduled to undergo cardiac catheterization.Interventions CO data triplets were obtained simultaneously from the cardiometry device ICON (Osypka Medical, Berlin, Germany) and PAC at the following predefined time points-(1) T1: 5 minutes after arterial and venous cannulation and (2) T2: 5 minutes postprocedure; the average of the 3 readings was calculated. Reliability analysis and Bland-Altman analysis were performed to determine the limits of agreement, mean bias, and accuracy of the CO measured with EC.Measurements and main results The measured EC-cardiac index 4.22 (3.84-4.60) L/min/m 2 and PAC-cardiac index 4.26 (3.67-4.67) L/min/m 2 were statistically insignificant (p value>0.05) at T1. Bland-Altman analysis revealed a mean bias of 0.0051 L/min/m 2 and precision limits of±0.4927 L/min/m 2. The intraclass correlation coefficient was 0.789 and Cronbach's alpha was 0.652, indicating good reproducibility and internal consistency between the two techniques. Postcatheterization analysis also revealed strong agreement and reliability between the two techniques.Conclusions This study demonstrated that cardiac indices measured in children with a variety of structural heart diseases using EC reliably represent absolute values obtained using PAC. EC technology is simple and easy to use and offers noninvasive beat-to-beat tracking of CO and other hemodynamic parameters in children with structurally abnormal hearts.
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Multiple studies have evaluated EC in neonates and infants with congenital heart disease, reporting statistically significant variations in cardiac index and left ventricular ejection fraction among heart failure subgroups.
“Multiple studies have evaluated EC in neonates and infants with congenital heart disease, reporting statistically significant variations in cardiac index and left ventricular ejection fraction among heart failure subgroups [70].”
From Trends and Challenges in Noninvasive Hemodynamic Monitoring of Neonates Following Cardiac Surgery: A Narrative Review (2025) · cites this paper as [70]
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- Authors
- Narula, J., Chauhan, S., Ramakrishnan, S., & Gupta, S. K.
- Affiliations
- All India Institute of Medical Sciences (IN)
- Corresponding author
- Narula, Jitin
- Venue
- Journal of Cardiothoracic and Vascular Anesthesia
- Publisher
- Elsevier BV
- Published
- 2017-06
- Volume
- 31
- Issue
- 3
- Pages
- 912-917
- ISSN
- 1053-0770 (ISSN-L)
- OpenAlex
- W2565600233
- Cited by
- 39
- References
- 26
- Citations by year
- 2026: 2 · 2025: 2 · 2024: 1 · 2023: 5 · 2022: 6 · 2021: 7 · 2020: 7 · 2019: 4 · 2018: 3 · 2017: 2
- FWCI
- 3.32
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Journal of Cardiothoracic and Vascular Anesthesia (publishedVersion)
- PubMed (publishedVersion)
- Topics
- Health Sciences › Medicine › Surgery › Hemodynamic Monitoring and Therapy
- Health Sciences › Medicine › Epidemiology › Congenital Heart Disease Studies
- Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Cardiovascular Function and Risk Factors
- Keywords
- electrical cardiometry, cardiac output estimation, pulmonary artery catheterization, congenital heart disease, pediatric patients, hemodynamic monitoring, non-invasive cardiac output measurement, cardiac index, measurement agreement
- MeSH terms
- Adolescent, Blood Flow Velocity, Cardiac Output, Catheterization, Swan-Ganz, Child, Female, Cardiac Catheterization, Heart Defects, Congenital, Humans, Male, Prospective Studies, Rheology, Reproducibility of Results, Electric Impedance
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