生物电阻抗法与经胸超声心动图在早产儿过渡期心输出量测量中的一致性：一项单中心前瞻性研究。

Agreement of Cardiac Output Measurements between Bioreactance and Transthoracic Echocardiography in Preterm Infants during the Transitional Phase: A Single-Centre, Prospective Study.

机构信息

Division Neonatology, Department of Paediatrics and Child Health, Stellenbosch University and Tygerberg Children's Hospital, Cape Town, South Africa,

Division Neonatology, Department of Paediatrics and Child Health, Stellenbosch University and Tygerberg Children's Hospital, Cape Town, South Africa.

出版信息

Neonatology. 2020;117(3):271-278. doi: 10.1159/000506203. Epub 2020 Feb 28.

DOI:10.1159/000506203

PMID:32114576

Abstract

INTRODUCTION

Bioreactance cardiac output (CO) monitors are able to non-invasively and continuously monitor CO. However, as a novel tool to measure CO, it must be proven to be accurate and precise.

OBJECTIVE

To determine the agreement between CO measured with a bioreactance monitor and transthoracic echocardiography-derived left ventricular output parameters in preterm infants.

METHODS

This is a prospective observational study in 63 preterm neonates with non-invasive respiratory support, not requiring inotrope support. The infants underwent continuous bioreactance monitoring of CO and stroke volume (SV) and simultaneous transthoracic echocardiography every 6 h until 72 h of life.

RESULTS

The agreement between bioreactance and transthoracic echocardiography, for both SV and CO, was poor. The percentage error was 67.5% for SV and 71.6% for CO. The mean error was 60.4% for SV and 69.8% for CO. Bias was affected by numerous variables. After correcting for time, CO and SV bias were significantly affected by the presence of an open patent ductus arteriosus and the level of CO.

CONCLUSION

Bioreactance cannot be considered interchangeable with transthoracic echocardiography to measure CO in preterm infants during the transition phase. Agreement between bioreactance and other CO metrics should be assessed before concluding its accuracy or inaccuracy in neonates.

摘要

简介

生物电阻抗心输出量（CO）监测仪能够无创且连续地监测 CO。然而，作为一种新的 CO 测量工具，它必须被证明是准确和精确的。

目的

确定生物电阻抗监测仪测量的 CO 与经胸超声心动图衍生的左心室输出参数在早产儿中的一致性。

方法

这是一项在 63 名接受非侵入性呼吸支持、不需要正性肌力支持的早产儿中进行的前瞻性观察性研究。婴儿在生命的 72 小时内每 6 小时接受一次连续的生物电阻抗 CO 和每搏量（SV）监测以及同时进行经胸超声心动图检查。

结果

生物电阻抗和经胸超声心动图在 SV 和 CO 方面的一致性都很差。SV 的百分比误差为 67.5%，CO 的百分比误差为 71.6%。SV 的平均误差为 60.4%，CO 的平均误差为 69.8%。偏倚受许多变量的影响。在对时间进行校正后，CO 和 SV 的偏倚显著受到动脉导管未闭的存在和 CO 水平的影响。