Non-invasive continuous cardiac output monitoring in infants with hypoxic ischaemic encephalopathy

J Perinatol. 2022 Dec;42(12):1622-1629. doi: 10.1038/s41372-022-01495-2. Epub 2022 Sep 2.

Abstract

Objective: To describe early, continuous, non-invasive measures of cardiac output (CO) and evolution over time in infants with hypoxic-ischaemic encephalopathy (HIE).

Study design: Prospective observational study of 44 infants with HIE (23 mild, 17 moderate, 4 severe) and 17 term controls. Infants with HIE had non-invasive CO monitoring (NICOM) continuously in the neonatal unit. Term controls had NICOM recorded at 6 and 24 h. A mixed-modelling approach was used to assess change in CO over time by group.

Results: Infants with moderate HIE have significantly lower CO than the mild group at all timepoints (10.7 mls/kg/min lower, 95% CI:1.0,20.4, p = 0.03) which increases over time, driven by a gradual increase in stroke volume (SV). CO increased further during rewarming predominantly due to an increase in HR.

Conclusion: TH has a significant impact on HR but SV appears largely unaffected. NICOM may provide a non-invasive, continuous, low-cost alternative to monitoring CO in infants with HIE however further research is warranted.

Publication types

  • Observational Study
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Cardiac Output
  • Humans
  • Hypothermia, Induced*
  • Hypoxia-Ischemia, Brain* / diagnosis
  • Hypoxia-Ischemia, Brain* / therapy
  • Infant, Newborn
  • Monitoring, Physiologic
  • Prospective Studies
  • Stroke Volume