Concordance entre ultrasonic cardiac output monitor et échocardiographie transthoracique pour la mesure de l’index cardiaque chez le nouveau-né
DOI :
https://doi.org/10.62438/tunismed.v102i9.5095Mots-clés :
Cardiac output, nouveau-né, échocardiographie, surveillance, USCOM, surveillance non invasive du débit cardiaqueRésumé
Objectif : Evaluer la concordance de l’index cardiaque (IC) mesuré par Ultrasonic cardiac output monitor (USCOM) et par echocardiographie transthoracique (ETT) chez le nouveau-né
Design : Étude prospective observationnelle durant une période de 3 mois
Lieu: Service de réanimation pédiatrique polyvalente de l’hôpital d’enfants Béchir hamza de Tunis
Patients: Tous les nouveau-nés n’ayant pas de trachéotomie et non porteurs de cardiopathies congénitales et admis au service de réanimation pédiatrique durant la période d’étude ont été inclus dans l’étude.
Interventions: Des mesures appariées et consécutives de l’IC par USCOM et ETT ont été réalisées chez tous les patients par 2 opérateurs différents. Trois mesures consécutives chez tous les nouveau-nés ont été réalisées par chaque opérateur.
La concordance des mesures de l’IC entre USCOM et ETT a été évaluée par l’analyse de Bland-Altman et le calcul du pourcentage d’erreur
Résultats : Quarante-deux nouveau-nés ont été étudiés avec en moyenne (déviation standard) un âge gestationnel de 36 SA ( 5 jours), un âge chronologique de 1jour (1,09) , et un poids 2,9 kg (0,87). La détresse respiratoire (75%) était la principale cause d’admission. Au moment de l’étude , 33 (75.%) patients étaient ventilés artificiellement. Les mesures par USCOM surestimaient l’IC avec un biais de 1,2l/min/m2 avec une précision de 1.08 l/min/m2.
Le pourcentage d’erreur de l’USCOM vs ETT était 54.9%.
Conclusions : La concordance des mesures de l’IC par les 2 techniques est faible. Les 2 techniques ne peuvent pas être interchangeables
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Références
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