Comparison between Pressure Recording Analytical Method and Fick Method to Measure Cardiac Output in Pediatric Cardiac Surgery

Demetrio Pittarello1, *, Vladimiro Vida2, Guido Di Gregorio1, Gianclaudio Falasco1, Giovanni Stellin2, Carlo Ori1
1 Department of Medicine, Anesthesia and Intesive Care Unit, University of Padova, Padova, Italy
2 Department of Cardio Thoracic and Vascular Sciences, Pediatric and Congenital Cardiac Surgery Unit, University of Padova, Padova, Italy

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Creative Commons License
© 2018 Pittarello et al.

open-access license: This is an open access article distributed under the terms of the Creative Commons Attribution 4.0 International Public License (CC-BY 4.0), a copy of which is available at: ( This license permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.

* Address correspondence to this author at the Department of Medicine, Anesthesia and Intesive Care Unit, University of Padova, via Gallucci, 13 35121 Padova, Italy; Tel: +39 0498213090; E-mail:



There is an increased interest in methods of objective cardiac output measurement in pediatric cardiac surgery. Several techniques are available, but have limitations, among the new technologies pressure recording analytical method with MostCare (MostCare-PRAM), a minimally invasive hemodynamic monitoring system, represents a novel arterial pulse contour method that does not require calibration. For this reason, we compared the MostCare-PRAM vs the Fick method for estimation of cardiac output.


We studied prospectively 13 pediatric patients who underwent cardiac surgery and compared intraoperatively Cardiac Index (CI) measured with the MostCare-PRAM with the CI measured with the Fick method. We also measured Cardiac Cycle Efficiency (CCE) and maximal arterial pressure/time ratio (dp/dt max) and compared with Fick method.


The data showed good agreement between CI Fick and CI MostCare-PRAM (r = 0.93 and R2= 0.86; p < 0.0001) and also between CCE (r = 0.82 and R2 = 0.67; p < 0.001) and dp/dt (r = 0.84; R2 = 0.81; p < 0.001) with CI measured with Fick method.


In pediatric patients submitted to cardiac surgery, the MostCare-PRAM seems to estimate CI with a good level of agreement with the Fick method measurements.

Keywords: Pediatric cardiac output, PRAM, Pediatric cardiac surgery, Fick method, Cardiac index, Cardiac cycle.