PT - JOURNAL ARTICLE AU - Benjamim Ficial AU - Elena Bonafiglia AU - Ezio M Padovani AU - Maria A Prioli AU - Anna E Finnemore AU - David J Cox AU - Kathryn M Broadhouse AU - Anthony N Price AU - Giuliana Durighel AU - Alan M Groves TI - A modified echocardiographic approach improves reliability of superior vena caval flow quantification AID - 10.1136/archdischild-2015-309523 DP - 2017 Jan 01 TA - Archives of Disease in Childhood - Fetal and Neonatal Edition PG - F7--F11 VI - 102 IP - 1 4099 - http://fn.bmj.com/content/102/1/F7.short 4100 - http://fn.bmj.com/content/102/1/F7.full SO - Arch Dis Child Fetal Neonatal Ed2017 Jan 01; 102 AB - Objective To assess accuracy and repeatability of a modified echocardiographic approach to quantify superior vena cava (SVC) flow volume that uses a short-axis view to directly measure SVC area and a suprasternal view to measure flow velocity, both at the level of the right pulmonary artery.Setting Three tertiary-level neonatal intensive care units.Design This was a multicentre, prospective, observational study. Accuracy of the traditional and modified approach was first assessed by comparing echo measurements according to both techniques with Phase contrast MRI (PCMRI) assessments, in a cohort of 10 neonates. In a second cohort of 40 neonates, intraobserver scan–rescan repeatability and interobserver analysis–reanalysis repeatability were assessed by repeated SVC flow echo measurements, according to both techniques.Results The traditional echocardiographic approach to assessment of SVC flow had a moderate agreement with PCMRI (r2 0.259), a scan–rescan intraobserver repeatability index (RI) of 37% (limits of agreement (LOA) −47/+51 mL/kg/min) and an interobserver analysis–reanalysis RI of 31% (LOA −38/+40 mL/kg/min). The modified approach showed a stronger agreement with PCMRI (r2 0.775), an improved intraobserver scan–rescan repeatability (RI 22%, LOA −24/+18 mL/kg/min) and improved interobserver analysis–reanalysis repeatability (RI 18%, LOA −18/+20 mL/kg/min).Conclusions Echocardiographic assessment of SVC flow volume by tracing area from a short-axis view and measuring velocity–time integral from a suprasternal view offered an improvement in accuracy and repeatability, building on the traditional approach previously described.