Ultrasound cardiac output monitor inter-rater agreement in pediatric intensive care unit

Objective: Although Ultrasound Cardiac Output Measurement (USCOM) is relatively simple to operate, its reliability for novice user needs to be assessed. This study aims to determine inter-rater agreement of USCOM between pediatric residents as novices and pediatric intensivist as experienced operator. Design: An observational study. Setting: A single-center study in Pediatric Intensive Care Unit. Patients and participants: Pediatric residents underwent in-house training and 20 practice scans, followed by blinded trans-aortic USCOM cardiac index (CI) measurements made by one . of two randomly selected pediatric residents paired with one pediatric intensivist. CI, its cat-egorization and image quality, were noted. Measurements and results: Paired measurements were performed on 48 subjects. Median of subjects age were 2 years (1 month to less than 18-year-old). Spearman�s rank showed strong positive correlation of CI (r<inf>s</inf>=0.77; 95 CI=0.62-0.86). Inter-rater agreement by Co-hen�s kappa showed substantial agreement on CI (ĸ=0.78). Conclusion: Following training, pediatric residents were able to measure CI using USCOM with substantial inter-rater agreement. © 2021 Elsevier B.V., All rights reserved.