Electrical velocimetry for non-invasive monitoring of the closure of the ductus arteriosus in preterm infants

Blanca, Ana Rodríguez Sánchez de la; Luna, Manuel Sánchez; González‐Pacheco, Noelia; Arriaga-Redondo, María; Patiño, Nelia Navarro

doi:10.1007/s00431-017-3063-0

Cited by 12 publications

(5 citation statements)

References 22 publications

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“…Various concerns regarding the accuracy of these non-invasive cardiac output monitors have been raised in adult and pediatric medicine ( 37 , 38 , 46 ). Despite this, these monitors have been used in neonatology in research and clinical environments for diverse scenarios: monitoring transition at birth ( 47 , 48 ), cardiac adaptation after birth ( 49 ), patent ductus arteriosus (PDA)diagnosis ( 50 ), PDA ligation ( 29 ), PDA medical therapy ( 51 ), monitoring congenital heart disease ( 52 , 53 ), managing neonatal hemodynamic shock ( 54 ) and sepsis ( 55 ), and to predict clinical outcomes ( 56 ).…”

Section: Discussionmentioning

confidence: 99%

Accuracy and Trending Ability of Electrical Biosensing Technology for Non-invasive Cardiac Output Monitoring in Neonates: A Systematic Qualitative Review

et al. 2022

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BackgroundElectrical biosensing technology (EBT) is an umbrella term for non-invasive technology utilizing the body’s fluctuating resistance to electrical current flow to estimate cardiac output. Monitoring cardiac output in neonates may allow for timely recognition of hemodynamic compromise and allow for prompt therapy, thereby mitigating adverse outcomes. For a new technology to be safely used in the clinical environment for therapeutic decisions, it must be proven to be accurate, precise and be able to track temporal changes. The aim of this systematic review was to identify and analyze studies that describe the accuracy, precision, and trending ability of EBT to non-invasively monitor Left ventricular cardiac output and/or stroke volume in neonates.MethodsA qualitative systematic review was performed. Studies were identified from PubMed NCBI, SCOPUS, and EBSCOHost up to November 2021, where EBT technologies were analyzed in neonates, in comparison to a reference technology. Outcome measures were bias, limits of agreement, percentage error for agreement studies and data from 4-quadrant and polar plots for trending studies. Effect direction plots were used to present results.ResultsFifteen neonatal studies were identified, 14 for agreement and 1 for trending analysis. Only thoracic electrical biosensing technology (TEBT), with transthoracic echocardiography (TTE) as the comparator, studies were available for analyzes. High heterogeneity existed between studies. An equal number of studies showed over- and underestimation of left ventricular output parameters. All studies showed small bias, wide limits of agreement, with most studies having a percentage error >30%. Sub-analyses for respiratory support mode, cardiac anomalies and type of technology showed similar results. The single trending study showed poor concordance, high angular bias, and poor angular concordance.DiscussionOverall, TEBT shows reasonable accuracy, poor precision, and non-interchangeability with TTE. However, high heterogeneity hampered proper analysis. TEBT should be used with caution in the neonatal population for monitoring and determining therapeutic interventions. The use of TEBT trend monitoring has not been sufficiently studied and requires further evaluation in future trials.

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Section: Discussionmentioning

confidence: 99%

Accuracy and Trending Ability of Electrical Biosensing Technology for Non-invasive Cardiac Output Monitoring in Neonates: A Systematic Qualitative Review

et al. 2022

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“…Infants treated for a PDA were found to have lower mean BP, CO, and SV compared to untreated, but after adjustment for GA and birth weight, all parameters except mean BP were found to be non-significant. In contrast, Rodríguez et al (52) monitored infants undergoing treatment of PDA (three ibuprofen doses) using EC. They reported a significant decrease in CO indexed for body weight (0.24 vs. 0.29 L/kg/min; P 0.03) after 72 h. Hsu et al ( 53) found infants with PDA had higher pre-treatment baseline CO determined by EC compared to non-PDA infants.…”

Section: Patent Ductus Arteriosusmentioning

confidence: 99%

Non-invasive Cardiac Output Monitoring in Neonates

et al. 2021

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Circulatory monitoring is currently limited to heart rate and blood pressure assessment in the majority of neonatal units globally. Non-invasive cardiac output monitoring (NiCO) in term and preterm neonates is increasing, where it has the potential to enhance our understanding and management of overall circulatory status. In this narrative review, we summarized 33 studies including almost 2,000 term and preterm neonates. The majority of studies evaluated interchangeability with echocardiography. Studies were performed in various clinical settings including the delivery room, patent ductus arteriosus assessment, patient positioning, red blood cell transfusion, and therapeutic hypothermia for hypoxic ischemic encephalopathy. This review presents an overview of NiCO in neonatal care, focusing on technical and practical aspects as well as current available evidence. We discuss potential goals for future research.

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“…There is a similar study utilizing EC to monitor CO during attempted pharmacological closure of PDA by intravenous ibuprofen in preterm infants [23], of which, a fall in median CO EC from 290 to 240 ml/kg/min (17%) 72 h after the initiation of treatment was found. However, the study is limited by its small case number (6 responders) and a wide overlap of CO EC between baseline and 72 h after the first dose ibuprofen.…”

Section: Discussionmentioning

confidence: 99%

Baseline cardiac output and its alterations during ibuprofen treatment for patent ductus arteriosus in preterm infants

Hsu

et al. 2019

BMC Pediatr

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Background Infants with hemodynamically significant patent ductus arteriosus (PDA) may physiologically compensate with a supranormal cardiac output (CO). As such, a supranormal CO may be a surrogate marker for a significant PDA or indicate a failed response to PDA closure by ibuprofen. Electrical cardiometry (EC) is an impedance-based monitor that can continuously and non-invasively assess CO (CO EC ). We aimed to trend CO EC through ibuprofen treatment for PDA in preterm infants. Methods We reviewed our database of preterm infants receiving ibuprofen for PDA closure. Response to ibuprofen was defined as no ductal flow in echocardiography ≤24 h after treatment. Responders were compared with gestational age (GA) and postnatal age matched non-responders and their trends of CO EC were compared. Both groups’ baseline CO EC were further compared to the reference infants without PDA. Results Eighteen infants (9 responders and 9 non-responders) with median (interquatile range) GA 27.5 (26.6–28.6) weeks, birthweight 1038 (854–1218) g and age 3.5 (3.0–4.0) days were studied. There were positive correlations between CO EC and ductal diameter and left atrium/ aortic root ratio (r = 0.521 and 0.374, p < 0.001, respectively). Both responders and non-responders had significantly higher baseline CO EC than the reference. Although there was no significant within-subject alteration of CO EC during ibuprofen treatment, there was a between-subject difference indicating non-responders had generally higher CO EC . Conclusions The changes of CO EC during pharmacological closure of PDA is less drastic compared to surgical closure. Infants with PDA had higher baseline CO EC compared to those without PDA, and non-responders had higher CO EC especially at baseline compared to responders.

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Electrical velocimetry for non-invasive monitoring of the closure of the ductus arteriosus in preterm infants

Cited by 12 publications

References 22 publications

Accuracy and Trending Ability of Electrical Biosensing Technology for Non-invasive Cardiac Output Monitoring in Neonates: A Systematic Qualitative Review

Accuracy and Trending Ability of Electrical Biosensing Technology for Non-invasive Cardiac Output Monitoring in Neonates: A Systematic Qualitative Review

Non-invasive Cardiac Output Monitoring in Neonates

Baseline cardiac output and its alterations during ibuprofen treatment for patent ductus arteriosus in preterm infants

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