Noninvasive Cardiac Output Monitoring in Paediatric Cardiac Surgery: Correlation between Change in Thoracic Fluid Content and Change in Patient Body Weight

Objective: Change in thoracic fluid content (TFC) derived via a bioreactance technique with a noninvasive cardiac output monitoring device (NICOM) reportedly shows a good correlation with the amount of fluid removed. The present study prospectively evaluated the utility and clinical application of TFC in the intraoperative fluid management of paediatric patients with congenital heart disease, undergoing cardiac surgery with bioreactance-based noninvasive monitoring. Methods: Haemodynamic parameters, patient body weight and parameters derived from the NICOM device (including cardiac output, cardiac index, TFC, percentage change in TFC compared with baseline [TFCd0%] and stroke volume variation) were recorded after anaesthesia induction but before surgical incision, and just before departure from the operating room to the intensive care unit. Results: In the 80 paediatric patients included in this study, linear regression analyses demonstrated good correlations between body weight gain and TFCd0%, between body weight gain % and TFCd0%, and between intra -operative fluid balance and TFCd0%. Conclusion: TFCd0% may be a useful indicator for intraoperative fluid management in paediatric patients with congenital heart disease, undergoing cardiac surgery.