RT Journal Article
SR Electronic
T1 A modified echocardiographic approach improves reliability of superior vena caval flow quantification
JF Archives of Disease in Childhood - Fetal and Neonatal Edition
JO Arch Dis Child Fetal Neonatal Ed
FD BMJ Publishing Group Ltd and Royal College of Paediatrics and Child Health
SP F7
OP F11
DO 10.1136/archdischild-2015-309523
VO 102
IS 1
A1 Benjamim Ficial
A1 Elena Bonafiglia
A1 Ezio M Padovani
A1 Maria A Prioli
A1 Anna E Finnemore
A1 David J Cox
A1 Kathryn M Broadhouse
A1 Anthony N Price
A1 Giuliana Durighel
A1 Alan M Groves
YR 2017
UL http://fn.bmj.com/content/102/1/F7.abstract
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.