• Holger Schiffmann, Bernhard Erdlenbruch, Dominique Singer, Sybille Singer, Egbert Herting, Andreas Hoeft, and Wolfgang Buhre.
• Department of Pediatrics, University of Göttingen, Göttingen, Germany. schiffi@med.uni-goettingen.de
• J. Cardiothorac. Vasc. Anesth. 2002 Oct 1;16(5):592-7.

ObjectiveTo assess cardiac output, intrathoracic blood volume, global end-diastolic volume, and extravascular lung water in critically ill neonates and small infants using transpulmonary indicator dilution.DesignProspective, observational, clinical study.SettingPediatric intensive care unit in a university hospital.ParticipantsCritically ill neonates and small infants suffering from severe heart failure, respiratory failure, or sepsis (n = 10).InterventionsA total of 194 transpulmonary indicator dilution measurements were done. Global end-diastolic volume, intrathoracic blood volume, and stroke volume were measured and compared with standard hemodynamic parameters during the clinical course and before and after volume loading (16 +/- 3.7 mL/kg of 10% albumin solution) in 8 of 10 patients.Measurements And Main ResultsA positive correlation was found for stroke volume index versus global end-diastolic volume (r = 0.76, p < 0.001) and intrathoracic blood volume (r = 0.56, p < 0.001). In contrast, no correlation was observed for stroke volume index versus central venous pressure. Volume loading resulted in significant increases in stroke volume index (p < 0.01), global end-diastolic volume (p < 0.01), and intrathoracic blood volume (p < 0.01); whereas central venous pressure, heart rate, mean arterial pressure, and extravascular lung water remained unchanged.ConclusionTranspulmonary indicator dilution enables measurement of cardiac output and intravascular volume status in critically ill neonates and infants at the bedside. The effects of volume loading on cardiac preload and effective change in stroke volume can be monitored by this technique, whereas central venous pressure was not indicative of changes in intravascular volume status.Copyright 2002, Elsevier Science (USA). All rights reserved.

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