REVIEW

Monitoring cardiac function in intensive care

S M Tibby, I A Murdoch

Department of Paediatric Intensive Care, Guy’s Hospital, London SE1 9RT, UK

Correspondence to:
Dr S Tibby, Department of Paediatric Intensive Care, Guy’s Hospital, London SE1 9RT, UK;
Shane.Tibby{at}gstt.sthames.nhs.uk

Systolic cardiac function results from the interaction of four interdependent factors: heart rate, preload, contractility, and afterload. Heart rate can be quantified easily at the bedside, while preload estimation has traditionally relied on invasive pressure measurements, both central venous and pulmonary artery wedge. These have significant clinical limitations; however, adult literature has highlighted the superiority of several novel preload measures. Measurement of contractility and afterload is difficult; thus in clinical practice the bedside assessment of cardiac function is represented by cardiac output. A variety of techniques are now available for cardiac output measurement in the paediatric patient. This review summarises cardiac function and cardiac output measurement in terms of methodology, interpretation, and their contribution to the concepts of oxygen delivery and consumption in the critically ill child.

Keywords: intensive care; cardiac function

Abbreviations: CO, cardiac output; ICU, intensive care unit; SVR, systemic vascular resistance

CiteULike    Complore    Connotea    Del.icio.us    Digg    Reddit    Technorati    What's this?

This article has been cited by other articles:

• Liakopoulos, O. J., Ho, J. K., Yezbick, A., Sanchez, E., Naddell, C., Buckberg, G. D., Crowley, R., Mahajan, A. (2007). An Experimental and Clinical Evaluation of a Novel Central Venous Catheter with Integrated Oximetry for Pediatric Patients Undergoing Cardiac Surgery. Anesth. Analg. 105: 1598-1604 [Abstract] [Full Text]  
• Groves, A. M., Kuschel, C. A., Skinner, J. R. (2006). International Perspectives: The Neonatologist as an Echocardiographer. NeoReviews 7: e391-e399 [Full Text]  
• Sumpelmann, R., Schuerholz, T., Marx, G., Hartel, D., Hecker, H., Ure, B. M., Jesch, N. K. (2006). Haemodynamic, acid-base and blood volume changes during prolonged low pressure pneumoperitoneum in rabbits. Br J Anaesth 96: 563-568 [Abstract] [Full Text]