Cardiac output measurement in preterm neonates: validation of USCOM against echocardiography
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KeywordsCardiac Output Flow Volume Preterm Neonate Aortic Diameter Haemodynamic Change
Objective measurement of cardiac output (CO) in preterm neonates is important for optimisation of haemodynamic management, and may have outcome benefits. Doppler ultrasound is the preferred method for measurement of CO; however, the pulmonary and aortic diameters for calculating flow volumes are small, and measurement using 2D ultrasound requires expertise and experience, particularly for analysis of transpulmonary flow. The USCOM (USCOM Ltd, Sydney, Australia) is a novel 2D independent device using CW Doppler and anthropometrics to determine both right and left flow volumes. The device is simpler to operate and less expensive than the conventional echocardiography.
This study was to compare 2D echo and USCOM CO measurements in preterm neonates.
After IRB approval 66 paired measures of transpulmonary CO were acquired in 37 preterm neonates (mean weight 1.13 ± 0.47 kg) using conventional echocardiography, combining 2D and CW Doppler, and the USCOM device. Signals were acquired and analysed independently and in a blinded fashion, and values compared by two-tailed t tests and Bland-Altman bias analysis.
These results suggest that the USCOM is as accurate for measurement of neonatal CO as conventional echocardiography, and may be a simple cost-effective alternative for neonatal haemodynamic management.