Beschreibung:
<jats:title>Summary</jats:title><jats:sec><jats:title>Background</jats:title><jats:p>It is currently uncertain which hemodynamic monitoring device reliably measures stroke volume and tracks cardiac output changes in pediatric cardiac surgery patients.</jats:p></jats:sec><jats:sec><jats:title>Objective</jats:title><jats:p>To evaluate the difference between stroke volume index (<jats:styled-content style="fixed-case">SVI</jats:styled-content>) measured by pressure recording analytical method (<jats:styled-content style="fixed-case">PRAM</jats:styled-content>) and bioreactance and their ability to track changes after a therapeutic intervention.</jats:p></jats:sec><jats:sec><jats:title>Methods</jats:title><jats:p>A single‐center prospective observational cohort study in children undergoing cardiac surgery with cardiopulmonary bypass (<jats:styled-content style="fixed-case">CPB</jats:styled-content>) was conducted. Twenty children below 20 kg with median (interquartile range) weight of 5.3 kg (4.1–7.8) and age of 6 months (3–20) were enrolled. Data were collected after anesthesia induction, at the end of <jats:styled-content style="fixed-case">CPB</jats:styled-content>, before fluid administration and after fluid administration. Overall, median‐<jats:styled-content style="fixed-case">IQR PRAM SVI</jats:styled-content> values (23 ml·m<jats:sup>−2</jats:sup>, 19–27) were significantly higher than bioreactance <jats:styled-content style="fixed-case">SVI</jats:styled-content> (15 ml·m<jats:sup>−2</jats:sup>, 12–25, <jats:italic>P</jats:italic> = 0.0001). Correlation (<jats:italic>r</jats:italic><jats:sup>2</jats:sup>) between the two methods was 0.15 (<jats:italic>P</jats:italic> = 0.0003). The mean difference between the measurements (bias) was 5.7 ml·m<jats:sup>−2</jats:sup> with a standard deviation of 9.6 (95% limits of agreement ranged from −13 to 24 ml·m<jats:sup>−2</jats:sup>). Percentage error was 91.7%. Baseline <jats:styled-content style="fixed-case">SVI</jats:styled-content> appeared to be similar, but <jats:styled-content style="fixed-case">PRAM SVI</jats:styled-content> was systematically greater than bioreactance thereafter, with the highest gap after the fluid loading phase: 13 (12–18) ml·m<jats:sup>−2</jats:sup> vs. 23 (19–25) ml·m<jats:sup>−2</jats:sup>, respectively, <jats:italic>P</jats:italic> = 0.0013. A multivariable regression model showed that a significant independent inverse correlation with patients' body weight predicted the <jats:styled-content style="fixed-case">CI</jats:styled-content> difference between the two methods after fluid challenge (β coefficient −0.12, <jats:italic>P</jats:italic> = 0.013).</jats:p></jats:sec><jats:sec><jats:title>Conclusions</jats:title><jats:p>Pressure recording analytical method and bioreactance provided similar <jats:styled-content style="fixed-case">SVI</jats:styled-content> estimation at stable hemodynamic conditions, while bioreactance <jats:styled-content style="fixed-case">SVI</jats:styled-content> values appeared significantly lower than <jats:styled-content style="fixed-case">PRAM</jats:styled-content> at the end of <jats:styled-content style="fixed-case">CPB</jats:styled-content> and after fluid replacement.</jats:p></jats:sec>