Non-invasive cardiac output measurement by EC and transthoracic echocardiography in the neonate
作者单位：Division of Neonatology Department Children's Hospital of Fudan University Heart Center Children's Hospital of Fudan University
会议名称：《2019长三角围产医学学术会议暨浙江省围产医学学术大会》
会议日期：2019年
学科分类：1002[医学-临床医学] 100202[医学-儿科学] 10[医学]
关 键 词：Electrical cardiometry Cardiac output Stroke volume Neonates
摘 要：Electrical cardiometry(EC), as a type of thoracic electrical bioimpedance, is a continuous noninvasive method for measuring cardiac output(CO). Although the accuracy of EC has been verified by compared to transthoracic echocardiography(via trans-aortic valve flow velocity time integral [EVVTI]), there are rare data on investigating the agreement with transthoracic echocardiography(via M-mode [EVMM]) as a widely used measurement method. This study aimed to investigate the agreement in CO measurements between EC and EVMM in the neonate. In this prospective observational study, simultaneous CO measurements carried by EC and by EVMM in neonatal intensive care patients. Data were compared by correlation, the coefficient of variation(CV) to evaluate the consistency of measurements, Bland–Altman analysis by calculated the bias(mean difference), precision(1.96×SD of the difference) and limits of agreement(bias± 1.96 SD). We enrolled 100 neonates(median GA: 33.79 weeks, IQR 29.79-38.96 weeks) and performed 109 paired between EC and EVMM. There was an excellent correlation for CO(r=0.86, p 0.001) measured by EC and EVMM. These correlations remained significant under different ventilation patterns and hemodynamic significance of the patent ducts arteriosus(PDA) in various birth weight infants. Coefficient of variation of CO was 53% and 43% for EC and EVMM, respectively. The level of agreement was little wide(mean bias=-0.15 L/min, precision=0.27 L/min). In conclusions, although the wide agreement of measurements of CO, EC has a good correlation with EVMM which not interfered by PDA, various respiratory conditions and different birth weight in neonates. Our results indicate that EC, as the non-invasive and continuous monitoring tools, has the potential to trend CO in the neonatal intensive care unit(NICU).