Application Of Electrical Cardiometry Monitoring In Postoperative Treatment Of Children With Congenital Heart Disease

Objective: To explore the guiding significance of electrical cardiometry(EC)monitoring in postoperative treatment of children with congenital heart disease.Methods: Children who underwent congenital heart disease(CHD)surgery in the affiliated Children's Hospital of Chongqing Medical University from December 2019 to May 2020 and were transferred to intensive care unit(ICU).They were randomly divided into ultrasound monitoring group,non-invasive monitoring group and routine treatment group.The stroke volume(SV),stroke volume variation(SVV)and the distensibility index of the inferior vena cava(dIVC)were measured by electronic cardiometry and transthoracic echocardiography(TTE)in the ultrasound monitoring group.In the non-invasive monitoring group,on the basis of routine treatment,the cardiac index(CI),SVV and systemic vascular resistance index(SVRI),were measured at 0 h,8 h,16 h and 24 h after operation to guide the clinical treatment.The routine treatment group was treated according to the routine monitoring index and clinical experience.Results: There was a significant positive correlation between SV measured by EC and TTE(r=0.932,P<0.01);Bland-Altman analysis showed that EC and TTE had a good consistency for the measurement of SV,the average differences were-0.29 mL,with an average percent error of 28.78%.There was a positive correlation between SVV measured by EC and dIVC measured by TTE(r=0.517,P<0.05).The time of mechanical ventilator time and ICU stay in the non-invasive monitoring group were shorter than those in the routine treatment group.The 24-hour net fluid volume intake per unit body weight,the incidence of low cardiac output syndrome and the incidence of severe outcome in the treatment group were lower than those in the routine treatment group(P<0.05).There was no significant difference in 24 h lactate clearance and vasoactive-inotropic scores(VIS)between the two groups.There was no significant difference in the incidence and mortality of peritoneal dialysis,cardiopulmonary resuscitation between the two groups(P>0.05).Conclusion: There is a good correlation and consistency between EC and TTE in monitoring the hemodynamics of children after CHD.The mechanical ventilation time and ICU stay time of children after CHD can be shortened under the guidance of EC,which has certain clinical significance.