Intra- and Inter-rater Agreement of Superior Vena Cava Flow and Right Ventricular Outflow Measurements in Late Preterm and Term Neonates

J Ultrasound Med. 2018 Sep;37(9):2181-2190. doi: 10.1002/jum.14568. Epub 2018 Feb 24.

Abstract

Objectives: To explore the intra- and inter-rater agreement of superior vena cava (SVC) flow and right ventricular (RV) outflow in healthy and unwell late preterm neonates (33-37 weeks' gestational age), term neonates (≥37 weeks' gestational age), and neonates receiving total-body cooling.

Methods: The intra- and inter-rater agreement (n = 25 and 41 neonates, respectively) rates for SVC flow and RV outflow were determined by echocardiography in healthy and unwell late preterm and term neonates with the use of Bland-Altman plots, the repeatability coefficient, the repeatability index, and intraclass correlation coefficients.

Results: The intra-rater repeatability index values were 41% for SVC flow and 31% for RV outflow, with intraclass correlation coefficients indicating good agreement for both measures. The inter-rater repeatability index values for SVC flow and RV outflow were 63% and 51%, respectively, with intraclass correlation coefficients indicating moderate agreement for both measures.

Conclusions: If SVC flow or RV outflow is used in the hemodynamic treatment of neonates, sequential measurements should ideally be performed by the same clinician to reduce potential variability.

Keywords: agreement; echocardiography (pediatric); right ventricular outflow; superior vena cava flow.

MeSH terms

  • Blood Flow Velocity
  • Cohort Studies
  • Echocardiography*
  • Female
  • Gestational Age
  • Heart Ventricles / diagnostic imaging
  • Heart Ventricles / physiopathology
  • Humans
  • Infant, Newborn
  • Infant, Premature
  • Male
  • Observer Variation
  • Prospective Studies
  • Reproducibility of Results
  • Vascular Diseases / diagnostic imaging
  • Vascular Diseases / physiopathology*
  • Vena Cava, Superior / diagnostic imaging
  • Vena Cava, Superior / physiopathology*
  • Ventricular Dysfunction, Right / diagnostic imaging
  • Ventricular Dysfunction, Right / physiopathology*