Journal article
Non-Invasive Cardiac Output Monitoring in Preterm Infants Undergoing Patent Ductus Arteriosus Ligation: A Comparison with Echocardiography
Neonatology (Basel, Switzerland), Vol.106(4), pp.330-336
11/2014
DOI: 10.1159/000365278
PMID: 25278031
Abstract
Background: Non-invasive cardiac output monitoring (NICOM; NICOM™) may be useful in the management of extremely premature preterm infants. Objectives: To evaluate a new bioreactance-based method of continuous NICOM in preterm infants following patent ductus arteriosus (PDA) ligation. Methods: Infants underwent three paired NICOM and echocardiography assessments of stroke volume (SV) and left ventricular output (LVO) in the postoperative period: at 1, 6-8, and 16-18 h postoperatively. NICOM- and echocardiography-measured SV and LVO during those periods were compared using Bland-Altman analysis and the intraclass correlation coefficient (ICC). Results: Twenty-five infants with a median (interquartile range) gestational age and birth weight of 25.0 weeks (24.5-25.9) and 700 g (615-775), respectively, were included. The overall systematic bias (limits of agreement) across all time points between the NICOM and echocardiography SV readings was 39% (8-69) with NICOM consistently underestimating echocardiography values. There was moderate consistency between NICOM and echocardiography SV values (ICC 0.78, p < 0.001). Compared with the 1-hour scans, the 6- to 8- and 16- to 18-hour scans had increased biases of 7.9% (95% CI 2.5-13.2) and 9.7% (95% CI 3.6-15.8), respectively. Conclusion: Continuous LVO measurement using NICOM was feasible and demonstrated a consistent systematic bias compared with echocardiography in unstable extremely preterm infants without a PDA ligation. NICOM may be used as a trending tool for continuous monitoring in this population, but wide limits of agreement and increasing bias over time suggest it is not interchangeable with echocardiography.
Details
- Title: Subtitle
- Non-Invasive Cardiac Output Monitoring in Preterm Infants Undergoing Patent Ductus Arteriosus Ligation: A Comparison with Echocardiography
- Creators
- Dany E WeiszAmish JainJoseph TingPatrick J McNamaraAfif EL-Khuffash
- Resource Type
- Journal article
- Publication Details
- Neonatology (Basel, Switzerland), Vol.106(4), pp.330-336
- DOI
- 10.1159/000365278
- PMID
- 25278031
- ISSN
- 1661-7800
- eISSN
- 1661-7819
- Number of pages
- 7
- Language
- English
- Date published
- 11/2014
- Academic Unit
- Stead Family Department of Pediatrics; Neonatology; Internal Medicine
- Record Identifier
- 9984093312802771
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