Validation of Minimally Invasive Ultrasound Indicator Dilution Technique in Critically Ill Children
| Status: | Completed |
|---|---|
| Conditions: | Cardiology, Hospital |
| Therapuetic Areas: | Cardiology / Vascular Diseases, Other |
| Healthy: | No |
| Age Range: | Any - 18 |
| Updated: | 4/2/2016 |
| Start Date: | June 2008 |
| End Date: | May 2011 |
| Contact: | Satish Rajagopal, MD |
| Email: | Satish.Rajagopal@CARDIO.CHBOSTON.ORG |
| Phone: | 617-355-7866 |
Validation of a Novel, Minimally Invasive Ultrasound Indicator Dilution Technique for Measuring Cardiac Index in Critically Ill Children
A novel method to measure cardiac index based on ultrasound indicator dilution technology
(UIDT) has been developed by Transonic Systems Inc. (Ithaca, NY, USA). The method overcomes
many of the limitations that have plagued the existing techniques used to measure cardiac
index in critically ill children.
In the proposed investigation, the investigators hope to validate a novel application of an
existing technology in critically ill infants and children. The primary aim of this study is
to determine the accuracy of cardiac index measured by UIDT when compared to the
gold-standard Fick technique. The primary hypothesis is that the average of three
consecutive measurements of cardiac index by UIDT will be accurate when compared to the Fick
technique. Secondary aims will be to determine the precision of the measurement, the
feasibility of the technique with regards to time required and any complications
encountered. An exploratory secondary aim of this study is to determine whether central
blood volume (CBV) derived from indicator transit time (ITT) correlates with central venous
pressure (CVP) and echocardiography derived measures of preload.
(UIDT) has been developed by Transonic Systems Inc. (Ithaca, NY, USA). The method overcomes
many of the limitations that have plagued the existing techniques used to measure cardiac
index in critically ill children.
In the proposed investigation, the investigators hope to validate a novel application of an
existing technology in critically ill infants and children. The primary aim of this study is
to determine the accuracy of cardiac index measured by UIDT when compared to the
gold-standard Fick technique. The primary hypothesis is that the average of three
consecutive measurements of cardiac index by UIDT will be accurate when compared to the Fick
technique. Secondary aims will be to determine the precision of the measurement, the
feasibility of the technique with regards to time required and any complications
encountered. An exploratory secondary aim of this study is to determine whether central
blood volume (CBV) derived from indicator transit time (ITT) correlates with central venous
pressure (CVP) and echocardiography derived measures of preload.
Inclusion Criteria:
- Age: less than 18 years.
- Admission to the CICU (8S) or MISICU (7S) of the Children's Hospital Boston.
- Presence of a central venous catheter with its tip in the superior vena cava or a
catheter in the pulmonary artery, documented by radiography.
- Requirement for mechanical ventilation via an endotracheal or tracheostomy tube.
- Presence of an arterial catheter.
- Patients must have a two ventricle circulation.
Exclusion Criteria:
- Endotracheal tube leak of greater than 10%.
- A significant air leak around the endotracheal tube makes VO2 impossible to measure.
- Presence of relevant intracardiac shunt.
- Intracardiac shunt will decrease the area under the arterial dilution curve
unpredictably, making cardiac index calculations unreliable.
- A patent foramen ovale and a single ventricular septal defect less than or equal to
2mm or an atrial septal defect less than or equal to 3mm will be considered
irrelevant for the purposes of this study.
- Previous enrollment in an incompatible research study.
- Current or prior diagnosis of heparin induced thrombocytopenia.
- A small amount of heparin is required to flush the extracorporeal AV loop that is
required for the measurements.
- Pneumothorax with ongoing air leak.
- An air leak will invalidate the measurement of VO2.
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