Comparison of Noninvasive Cardiac Output Monitoring by Electrical Cardiometry with Transthoracic Echocardiography in Postoperative Paediatric Cardiac Surgical Patients - A Prospective Observational Study

AIM: The present study was conducted to validate cardiac output (CO) and cardiac index (CI) obtained from electrical cardiometry (EC) ICON (®) with transthoracic echocardiography (TTE) in postoperative pediatric cardiac surgical patients. MATERIALS AND METHODS: A prospective observational study was conducted in 25 pediatric patients with age < 10 years who underwent elective cardiac surgery. DATA ANALYSIS: BlandAltman plot was constructed for interchangeability and Polar plot was constructed to know trending ability. RESULTS: A total of 250 datasets were analyzed. Spearman’s correlation coefficient for CO between ICON (®) and TTE showed good positive correlation (r = 0.850, 95% confidence interval 0.81 to 0.881, P <.0001). Moderate positive correlation was observed between ICON (®) and TTE for CI (r = 0.60, 95% confidence interval 0.515 to 0.674, P <.0001). Linear regression equations for CO and CI between ICON (®) and TTE were: y = 0.5230 + 0.8078 X (R(2) = 0.6597, P <.001) and y = 1.8350 + 0.5869 X (R(2) = 0.3985, P <.001) [y- ICON (®); X - TTE], respectively. BlandAltman plot for CO between ICON (®) and TTE showed a bias of 0.3012 with limits of agreement (LOA) being -0.69 to 1.3 and for CI bias was 0.6939 with LOA-2.1 to 3.5. Polar plot analysis showed an angular bias of 8.1750, with radial LOA being −13.74° to 30.08° for CO and angular bias of 6.6931, with radial LOA being −15.69° to 29.07° for CI. CONCLUSION: ICON (®) monitor-derived parameters are not interchangeable with the values derived from TTE. However, the ICON (®) monitor demonstrated a good trending ability for both CO and CI.