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It remains a great challenge to measure systemic blood flow in critically ill newborns, especially during the transitional period with intracardiac and extracardiac shunts. Due to technical restraints, size limitations, the necessity for a relatively large amount of blood withdrawn and possible indicator toxicity, many methods of cardiac output monitoring are not feasible, hence cardiac output is generally estimated from indirect parameters of systemic blood flow. In a former study we assessed the agreement for cardiac output using the ultrasound dilution method (UDCO) and ultrasound transit time-based measurement of main pulmonary blood flow in a juvenile piglet model without shunts [1]. In the present study we analyzed the influence of a left-to-right shunt on the agreement between UDCO and ultrasonic transit time pulmonary blood flow in a juvenile lamb model.

Cardiac output measurement is feasible in the presence of left-to-right shunt with ultrasound dilution method: a validation study in lambs