Kelsey McLaughlin1, Stephen P Wright2, John C P Kingdom3, John D Parker4. 1. Department of Medicine, Division of Cardiology, Mount Sinai Hospital, University of Toronto, ON; The Centre for Women's and Infant's Health at the Lunenfeld-Tanenbaum Research Institute, Mount Sinai Hospital, University of Toronto, ON; Department of Pharmacology and Toxicology, University of Toronto, ON. 2. Department of Medicine, Division of Cardiology, Mount Sinai Hospital, University of Toronto, ON; Institute of Medical Science, University of Toronto, ON. 3. The Centre for Women's and Infant's Health at the Lunenfeld-Tanenbaum Research Institute, Mount Sinai Hospital, University of Toronto, ON; Department of Obstetrics and Gynaecology, Division of Maternal-Fetal Medicine, Mount Sinai Hospital, University of Toronto, ON. 4. Department of Medicine, Division of Cardiology, Mount Sinai Hospital, University of Toronto, ON; Department of Pharmacology and Toxicology, University of Toronto, ON. Electronic address: john.parker@uhn.ca.
Abstract
OBJECTIVE: Non-invasive hemodynamic monitoring has the potential to be a valuable clinical tool for the screening and management of hypertensive disorders of pregnancy. The objective of this study was to validate the clinical utility of the non-invasive cardiac output monitoring (NICOM) system in pregnant women. METHODS: Twenty healthy pregnant women with a singleton pregnancy at 22 to 26 weeks' gestation were enrolled in this study. Measures of heart rate, stroke volume, and cardiac output were obtained through NICOM and compared with Doppler echocardiography. RESULTS: NICOM significantly overestimated measures of both stroke volume and cardiac output compared with Doppler echocardiography (95 ± 4 vs. 73 ± 4 mL, P < 0.0001; and 7.4 ± 0.2 vs. 5.6 ± 0.2 L/min, P < 0.0001; respectively). CONCLUSIONS: There is no gold standard for the measurement of cardiac output in the setting of pregnancy. However, once normal values have been established, NICOM has the potential to be a useful clinical tool for monitoring maternal hemodynamics in pregnant women. Further investigation regarding the validity of NICOM is required in larger populations of healthy and hypertensive pregnant women to determine whether this device is appropriate for maternal hemodynamic assessment during pregnancy.
OBJECTIVE: Non-invasive hemodynamic monitoring has the potential to be a valuable clinical tool for the screening and management of hypertensive disorders of pregnancy. The objective of this study was to validate the clinical utility of the non-invasive cardiac output monitoring (NICOM) system in pregnant women. METHODS: Twenty healthy pregnant women with a singleton pregnancy at 22 to 26 weeks' gestation were enrolled in this study. Measures of heart rate, stroke volume, and cardiac output were obtained through NICOM and compared with Doppler echocardiography. RESULTS: NICOM significantly overestimated measures of both stroke volume and cardiac output compared with Doppler echocardiography (95 ± 4 vs. 73 ± 4 mL, P < 0.0001; and 7.4 ± 0.2 vs. 5.6 ± 0.2 L/min, P < 0.0001; respectively). CONCLUSIONS: There is no gold standard for the measurement of cardiac output in the setting of pregnancy. However, once normal values have been established, NICOM has the potential to be a useful clinical tool for monitoring maternal hemodynamics in pregnant women. Further investigation regarding the validity of NICOM is required in larger populations of healthy and hypertensive pregnant women to determine whether this device is appropriate for maternal hemodynamic assessment during pregnancy.
Authors: Kelsey McLaughlin; Jianhong Zhang; Stephen J Lye; John D Parker; John C Kingdom Journal: J Am Heart Assoc Date: 2018-07-14 Impact factor: 5.501