R Song1, W Rich1, J H Kim1, N N Finer1, A C Katheria2. 1. Division of Neonatology, Department of Pediatrics, University of California San Diego, San Diego, California. 2. Neonatal Research Institute, Sharp Mary Birch Hospital for Women & Newborns, San Diego, California.
Abstract
BACKGROUND: Electrical cardiometry (EC) is a continuous noninvasive method for measuring cardiac output (CO), but there are limited data on premature infants. We evaluated the utility of EC monitoring by comparing the results obtained using EC to measurements of CO and systemic blood flow using echocardiography (ECHO). METHODS: In this prospective observational study, 40 preterm neonates underwent 108-paired EC and ECHO measurements. RESULTS: There were correlations between EC-CO and left ventricular output (LVO, p < 0.005) and right ventricular output (RVO, p < 0.005) but not with superior vena cava (r = 0.093, p = 0.177). Both RVO and LVO correlated with EC with and without a hemodynamically significant ductus arteriosus (p = 0.001 and 0.008, respectively). The level of agreement was decreased in infants ventilated by high-frequency oscillation ventilators (HFOV). The bias in HFOV was also positive compared with the negative biases found in other modes of ventilation. CONCLUSION: Given the correlation of EC with LVO, RVO, and lack of confounding effects of the ductus, our results suggest that EC has promise for trending CO in the preterm infant. However, given the limitations with mode of ventilation and the lack of correlation at low LVO values, further study is needed before this technology can be for routine use. Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.
BACKGROUND: Electrical cardiometry (EC) is a continuous noninvasive method for measuring cardiac output (CO), but there are limited data on premature infants. We evaluated the utility of EC monitoring by comparing the results obtained using EC to measurements of CO and systemic blood flow using echocardiography (ECHO). METHODS: In this prospective observational study, 40 preterm neonates underwent 108-paired EC and ECHO measurements. RESULTS: There were correlations between EC-CO and left ventricular output (LVO, p < 0.005) and right ventricular output (RVO, p < 0.005) but not with superior vena cava (r = 0.093, p = 0.177). Both RVO and LVO correlated with EC with and without a hemodynamically significant ductus arteriosus (p = 0.001 and 0.008, respectively). The level of agreement was decreased in infants ventilated by high-frequency oscillation ventilators (HFOV). The bias in HFOV was also positive compared with the negative biases found in other modes of ventilation. CONCLUSION: Given the correlation of EC with LVO, RVO, and lack of confounding effects of the ductus, our results suggest that EC has promise for trending CO in the preterm infant. However, given the limitations with mode of ventilation and the lack of correlation at low LVO values, further study is needed before this technology can be for routine use. Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.
Authors: Ana Rodríguez Sánchez de la Blanca; M Sánchez Luna; N González Pacheco; M Arriaga Redondo; N Navarro Patiño Journal: Eur J Pediatr Date: 2017-12-08 Impact factor: 3.183