Aisling A Garvey1,2,3, Roisin O'Neill1, Vicki Livingstone2,3, Andreea M Pavel1,2,3, Daragh Finn2,3, Geraldine B Boylan2,3, Deirdre M Murray2,3, Eugene M Dempsey4,5,6. 1. Department of Neonatology, Cork University Maternity Hospital, Wilton, Cork, Ireland. 2. INFANT Research Centre, University College Cork, Cork, Ireland. 3. Department of Paediatrics & Child Health, University College Cork, Cork, Ireland. 4. Department of Neonatology, Cork University Maternity Hospital, Wilton, Cork, Ireland. g.dempsey@ucc.ie. 5. INFANT Research Centre, University College Cork, Cork, Ireland. g.dempsey@ucc.ie. 6. Department of Paediatrics & Child Health, University College Cork, Cork, Ireland. g.dempsey@ucc.ie.
Abstract
OBJECTIVE: To describe early, continuous, non-invasive measures of cardiac output (CO) and evolution over time in infants with hypoxic-ischaemic encephalopathy (HIE). STUDY DESIGN: Prospective observational study of 44 infants with HIE (23 mild, 17 moderate, 4 severe) and 17 term controls. Infants with HIE had non-invasive CO monitoring (NICOM) continuously in the neonatal unit. Term controls had NICOM recorded at 6 and 24 h. A mixed-modelling approach was used to assess change in CO over time by group. RESULTS: Infants with moderate HIE have significantly lower CO than the mild group at all timepoints (10.7 mls/kg/min lower, 95% CI:1.0,20.4, p = 0.03) which increases over time, driven by a gradual increase in stroke volume (SV). CO increased further during rewarming predominantly due to an increase in HR. CONCLUSION: TH has a significant impact on HR but SV appears largely unaffected. NICOM may provide a non-invasive, continuous, low-cost alternative to monitoring CO in infants with HIE however further research is warranted.
OBJECTIVE: To describe early, continuous, non-invasive measures of cardiac output (CO) and evolution over time in infants with hypoxic-ischaemic encephalopathy (HIE). STUDY DESIGN: Prospective observational study of 44 infants with HIE (23 mild, 17 moderate, 4 severe) and 17 term controls. Infants with HIE had non-invasive CO monitoring (NICOM) continuously in the neonatal unit. Term controls had NICOM recorded at 6 and 24 h. A mixed-modelling approach was used to assess change in CO over time by group. RESULTS: Infants with moderate HIE have significantly lower CO than the mild group at all timepoints (10.7 mls/kg/min lower, 95% CI:1.0,20.4, p = 0.03) which increases over time, driven by a gradual increase in stroke volume (SV). CO increased further during rewarming predominantly due to an increase in HR. CONCLUSION: TH has a significant impact on HR but SV appears largely unaffected. NICOM may provide a non-invasive, continuous, low-cost alternative to monitoring CO in infants with HIE however further research is warranted.