Hemodynamic Monitoring of Stable Neonates Using Electrical Cardiometry in Comparison to Functional Echocardiography, A Cross-Sectional Study

Abstract

Abstract Background Hemodynamic monitoring is an essential component in the care of term and preterm infants in neonatal intensive care units (NICUs). Echocardiography (Echo) can provide real time assessment of cardiac function, loading conditions (preload and afterload) and cardiac output (CO), but it requires training and can only be obtained intermittently. Electrical cardiometry (EC) has been approved by FDA as a safe, non-invasive, accurate and reproducible technique for hemodynamic assessment in children and infants. Aim of the Work To evaluate the accuracy of the electrical cardiometry in comparison to functional echocardiography in hemodynamically stable neonates. Patients and Methods This cross-sectional agreement study was conducted in NICUs of Children hospital of Ain Shams University, between (01/03/2021- 31/08/2021), and was approved by the Ethics committee of Ain Shams University (approval no: - MS 336\2021). Hemodynamically stable neonates admitted during the study period were eligible for enrollment and were included if their age was less than 7 days. Neonates with congenital anomalies, those requiring or recovering from surgeries and those with sever neonatal sepsis were excluded. Results Ninety neonates were included (55.6% females, 44.4% males), (41 preterm, 49 full term). In all study population, there was positive correlation between EC and Echo for heart rate, stroke volume, cardiac output, and cardiac index (p-value <0.001 for all). For EC readings for all patients, Cardiac Performance Index (CPI) mean was 0.41 (ranged from 0.23 to 0.65 W/m2), Stroke Volume Variation (SVV) ranged from 10 - 40% with mean 18.53 %, Systemic Vascular Resistance Index (SVRI) range from 608 to 2886 dyn-sec/m2 (mean of 1482.2 dyn- sec/m2), and Total Fluid Content (TFC) ranged from 19 to 61 ml (mean was 34.3 ml). Conclusion Electrical cardiometry is a safe and convenient way of neonatal hemodynamic monitoring. Our data suggests the possible benefit of using EC continuously in monitoring the trend of hemodynamic parameters rather than comparing its measurements to Echocardiography. Further studies in larger number of patients are recommended.