Department of Paediatrics & Child Health, University College Cork, Cork, Ireland.
INFANT Research Centre, University College Cork, Cork, Ireland.
Neonatology. 2022;119(5):594-601. doi: 10.1159/000525755. Epub 2022 Jul 27.
The aim was to evaluate the agreement between cardiac output estimates obtained by electrical cardiometry (EC) and transthoracic echocardiography (TTE) in very preterm infants.
This is a single-center prospective observational study in infants born<32 weeks gestational age within 48 h of birth. Continuous EC was recorded and simultaneous TTE obtained on day 1 and day 2 of life. Blinded TTE measurements were performed within a 10 s timeframe using beat-to-beat EC data. The primary outcome was %error of left ventricular (LV) output in milliliters per kilogram per minute (cardiac index (CI)) obtained by TTE compared to LV-CI from EC. Secondary outcome parameters were bias, %bias, limits of agreement and include measures of right ventricular (RV) output and LV systolic time intervals.
Analysis was performed for 34 infants (median (IQR) gestational age 29 + 0 (24 + 5 to 30 + 6) weeks + days, birthweight 960 (748 to 1,490) grams) including 44 pairwise LV output measurements on 24 participants (22 on day 1 and day 2). The %error was 54% for LV-CI (EC: 214 (38) mL/kg/min vs. TTE: 163 (47) mL/kg/min). The %error was 78% for RV-CI (EC: 213 (37) mL/kg/min vs. TTE: 241 (77) mL/kg/min). While only LV-CI values affected LV-CI bias, signal quality, heart rate, and RV-CI values affected RV-CI bias.
EC is not interchangeable with TTE to estimate indices of LV or RV output in very preterm infants within the first 48 h postnatally. EC may not measure LV output distinctly in very preterm infants with intra- and extracardiac shunts.
本研究旨在评估电心计量（EC）和经胸超声心动图（TTE）在极早产儿心输出量估计中的一致性。
这是一项在出生后 48 小时内出生胎龄<32 周的婴儿中进行的单中心前瞻性观察研究。连续记录 EC，并在出生后第 1 天和第 2 天同时进行 TTE。在 10 秒的时间内，使用逐搏 EC 数据进行盲法 TTE 测量。主要结局是 TTE 测量的左心室（LV）输出百分比误差（毫升/千克/分钟）与 EC 测量的 LV-CI 相比。次要结局参数为偏倚、%偏倚、一致性界限以及包括右心室（RV）输出和 LV 收缩时间间隔的测量值。
对 34 名婴儿（中位数（IQR）胎龄 29+0（24+5 至 30+6）周+天，出生体重 960（748 至 1490）克）进行了分析，包括 24 名参与者中的 44 对 LV 输出测量值（22 名在第 1 天和第 2 天）。LV-CI 的百分比误差为 54%（EC：214（38）mL/kg/min 与 TTE：163（47）mL/kg/min）。RV-CI 的百分比误差为 78%（EC：213（37）mL/kg/min 与 TTE：241（77）mL/kg/min）。虽然只有 LV-CI 值会影响 LV-CI 偏倚，但信号质量、心率和 RV-CI 值会影响 RV-CI 偏倚。
在出生后 48 小时内，EC 不能与 TTE 互换以估计极早产儿的 LV 或 RV 输出指数。EC 可能无法在有心脏内和心脏外分流的极早产儿中准确测量 LV 输出。
