早产儿生物电阻抗心输出量趋势能力：单中心纵向研究。

Bioreactance Cardiac Output Trending Ability in Preterm Infants: A Single Centre, Longitudinal Study.

机构信息

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

Paediatric Cardiology Unit, Department of Paediatrics and Child Health, Stellenbosch University, Cape Town, South Africa.

出版信息

Neonatology. 2021;118(5):600-608. doi: 10.1159/000518656. Epub 2021 Sep 9.

DOI:10.1159/000518656

PMID:34518489

Abstract

INTRODUCTION

It is unknown whether bioreactance (BR) can accurately track cardiac output (CO) changes in preterm neonates.

METHODS

A prospective observational longitudinal study was performed in stable preterm infants (<37 weeks) during the first 72 h of life. Stroke volume (SV) and CO, as measured by BR and transthoracic echocardiography, were compared.

RESULTS

The mean gestational age (GA) was 31.3 weeks and mean birth weight (BW) was 1,563 g. Overall, 690 measurements were analysed for trending ability by 4-quadrant and polar plots. For non-weight-indexed measurements, 377 (54.6%) lay outside the 5% exclusion zone, the concordance rate was poor (77.2%) with a high mean angular bias (28.6°), wide limits of agreement and a poor angular concordance rate (17.4%). Neither GA, BW nor respiratory support mode affected trending data. Patent ductus arteriosus, postnatal age, and CO level had variable effects on trending data. Trending data for 5 and 10% exclusion zones were also compared.

CONCLUSION

The ability of BR to track changes in CO is not interchangeable with CO changes as measured by echocardiography. BR, as a trend monitor for changes in CO or SV to determine clinical decisions around interventions in neonatology, should be used with caution.

摘要

简介

目前尚不清楚生物电阻抗（BR）能否准确跟踪早产儿心输出量（CO）的变化。

方法

对生命最初 72 小时内稳定的早产儿（<37 周）进行前瞻性观察性纵向研究。比较 BR 和经胸超声心动图测量的每搏量（SV）和 CO。

结果

平均胎龄（GA）为 31.3 周，平均出生体重（BW）为 1563g。总体上，通过四象限和极坐标图分析了 690 次测量以进行趋势分析。对于未体重指数化的测量，377 次（54.6%）超出了 5%的排除区，一致性率较差（77.2%），平均角偏差较大（28.6°），一致性范围较宽，角一致性率较差（17.4%）。GA、BW 或呼吸支持模式均未影响趋势数据。动脉导管未闭、出生后年龄和 CO 水平对趋势数据有不同的影响。还比较了 5%和 10%排除区的趋势数据。