Neonatology
Original Paper
Non-Invasive Cardiac Output Monitoring in Neonates Using Bioreactance: A Comparison with EchocardiographyWeisz D.E.a · Jain A.a–c · McNamara P.J.b–e · EL-Khuffash A.a–caDepartment of Pediatrics, Mount Sinai Hospital, bDivision of Neonatology, The Hospital for Sick Children, cDepartment of Pediatrics, University of Toronto, dPhysiology and Experimental Medicine Program, The Hospital for Sick Children, and eDepartment of Physiology, University of Toronto, Toronto, Ont., Canada
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Article / Publication Details
Received: November 03, 2011
Accepted: February 15, 2012
Published online: April 11, 2012
Issue release date: June 2012
Number of Print Pages: 7
Number of Figures: 3
Number of Tables: 2
ISSN: 1661-7800 (Print)
eISSN: 1661-7819 (Online)
For additional information: https://www.karger.com/NEO
Abstract
Objectives: Non-invasive cardiac output monitoring is a potentially useful clinical tool in the neonatal setting. Our aim was to evaluate a new method of non-invasive continuous cardiac output (CO) measurement (NICOM™) based on the principle of bioreactance in neonates. Methods: In this prospective observational study, 10 neonates underwent 97 paired NICOM and echocardiography (echo) assessments of left ventricular output (LVO). For each neonate, NICOM measurements of left ventricular stroke volume (SV) and LVO over a 2- to 4-hour period were correlated with blinded, simultaneous, discrete echo measurements of SV and LVO. The precision and accuracy of the NICOM monitor relative to echo during periods of steady state were assessed. Results: The infants’ median birth weight was 2.72 kg (IQR 1.56–3.23 kg, range 1.44–4.00) and their median gestation was 37 weeks (IQR 31–40 weeks, range 31–41). Median NICOM SV and LVO readings were consistently lower than echo (2.6 ml [IQR 1.4–3.2, range 0.6–5.3] vs. 3.5 ml [IQR 2.1–4.4, range 1.1–6.8], and 400 ml/min [IQR 233–476] vs. 559 ml/min [IQR 386–652], p < 0.001). The NICOM LVO readings were lower than the echo readings by a mean of 153 ± 56 ml/kg. NICOM consistently under-read LVO by 31 ± 8%, and this systematic difference was constant across the range of LVOs obtained. There was a strong correlation between NICOM and echo measurements of LVO (r = 0.95, p < 0.001). Conclusion: Non-invasive cardiac output monitoring is feasible in neonates. Further validation studies in neonatal animal experimental models and human neonates need to be conducted before routine clinical use.
© 2012 S. Karger AG, Basel
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External Resources
Article / Publication Details
Received: November 03, 2011
Accepted: February 15, 2012
Published online: April 11, 2012
Issue release date: June 2012
Number of Print Pages: 7
Number of Figures: 3
Number of Tables: 2
ISSN: 1661-7800 (Print)
eISSN: 1661-7819 (Online)
For additional information: https://www.karger.com/NEO
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Copyright: All rights reserved. No part of this publication may be translated into other languages, reproduced or utilized in any form or by any means, electronic or mechanical, including photocopying, recording, microcopying, or by any information storage and retrieval system, without permission in writing from the publisher.Drug Dosage: The authors and the publisher have exerted every effort to ensure that drug selection and dosage set forth in this text are in accord with current recommendations and practice at the time of publication. However, in view of ongoing research, changes in government regulations, and the constant flow of information relating to drug therapy and drug reactions, the reader is urged to check the package insert for each drug for any changes in indications and dosage and for added warnings and precautions. This is particularly important when the recommended agent is a new and/or infrequently employed drug.
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