Development of a noninvasive optical and thermographic imaging protocol for identification of pediatric Low Cardiac Output Syndrome

Abstract

Low cardiac output syndrome (LCOS) describes a collection of clinical symptoms that can arise in pediatric patients after surgical correction of a congenital heart defect (CHD). The consequences of low cardiac output states carry significant morbidity and mortality in this population and motivates the need to find additional clinical markers to predict the onset of LCOS. Herein, a procedure for quantifying thermal images is described for a thermal (infrared) imaging system in the clinical setting. The described procedures utilized a coupled thermal and optical imaging system to noninvasively obtain serial thermographs of pediatric patients recovering from CHD surgery in a pediatric intensive care unit (PICU), at a frequency of every 30 seconds. A limited pilot study investigated the difference between normal and abnormal recovery profiles in two representative patients and assessed the preliminary ability of thermal imaging to identify the presence of LCOS. The quantified thermographic values were compared to monitored hemodynamic values to correlate changes in peripheral temperature with standard clinical markers of low cardiac output states. A decrease in core and peripheral temperature was observed immediately before a clinically reported hemodynamic event in one of the studies, supporting the hypothesis that changes in body temperature may precede abnormal hemodynamic values and major adverse events in postoperative recovery. The other study, of a normal recovery, served as a basis for comparison. While additional case analysis is required to strengthen noted observations, this work establishes a foundational process for obtaining, processing, and analyzing thermal images in a dynamic clinical environment.