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Feasibility of non-invasive cardiac output monitoring at birth using electrical bioreactance in term infants
  1. Karen Nora McCarthy1,
  2. Andrea Pavel1,
  3. Aisling A Garvey1,
  4. Ana-Louise Hawke1,
  5. Criona Levins1,
  6. Vicki Livingstone1,
  7. Eugene M Dempsey1,2
  1. 1 INFANT Research Centre, University College Cork College of Medicine and Health, Cork, Ireland
  2. 2 Department of Paediatrics and Child Health, University College Cork College of Medicine and Health, Cork, Ireland
  1. Correspondence to Dr Karen Nora McCarthy, INFANT Research Centre, University College Cork College of Medicine and Health, Cork T12 YN60, Ireland; karen.n.mccarthy{at}gmail.com

Abstract

Background Non-invasive cardiac output monitoring (NICOM) provides continuous estimation of cardiac output. This has potential for use in the delivery suite in the management of acutely depressed term infants. This study aims to measure cardiac output in term infants at delivery and in the first hours of life.

Methods Parents of term infants due to be born by elective caesarean section or vaginal delivery at Cork University Maternity Hospital, Ireland were approached in the antenatal period to participate. Cardiac output was measured using a CHEETAH NICOM device, which uses electrical bioreactance technology, at birth and at 2 hours of life.

Results Forty-nine newborns were included. The median gestational age was 39 (IQR: 39–40) weeks and the median birth weight was 3.50 (IQR: 3.14–3.91) kg. Cardiac output measurements were obtained at a median of 8 (IQR: 5–12) min of life. The mean (SD) cardiac output was 101 (24) mL/kg/min in the delivery room and 89 (22) mL/kg/min at 2 hours of life. There was a statistically significant decrease in cardiac output from birth to 2 hours of life (difference in mean (95% CI): 13.5 (9.2 to 17.9) mL/kg/min, p<0.001, n=47). There were no adverse effects associated with NICOM.

Discussion This technique is feasible and safe in the delivery room. Mean cardiac output measures using NICOM are lower than those found in studies which used echocardiography to determine cardiac output at birth.

  • non invasive cardiac output monitoring
  • neonatology
  • newborn
  • term
  • cardiac output
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Footnotes

  • Funding This work is supported by a Science Foundation Ireland research award (INFANT-12/RC/2272).

  • Competing interests None declared.

  • Patient consent for publication Not required.

  • Ethics approval Ethical approval was obtained from the Clinical Research Ethics Committee of the Cork Teaching Hospitals (ECM 4 (uu) 07/03/17 and ECM 3 (c) 05/09/17).

  • Provenance and peer review Not commissioned; externally peer reviewed.

  • Data availability statement Data are available upon reasonable request. Data are available by contacting the corresponding author.

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