الفهرس 
HEMODYNAMIC MONITORING IN NEONATESOnly 14 pages are availabe for public view
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Abstract
H
emodynamic monitoring is an essential component in the care of term and preterm infants in neonatal intensive care units. Echocardiography can provide real time assessment of cardiac function, loading conditions (preload and afterload) and (CO), but it requires training and can only be obtained intermittently.
Electrical cardiometry is a non-invasive, impedance-based device, that provides real-time cardiovascular assessment in an absolute number and can be used for continuous hemodynamic monitoring. The principle is related to changes in thoracic electrical impedance, which is mainly influenced by the degree of red blood cell (RBC) alignment in the aorta throughout the cardiac cycle.
The current study was conducted in NICUs of Children hospital of Ain Shams University, between (01/03/2021- 31/08/2021).
In the current study, we aimed to evaluate the accuracy and precision of EC in comparison to ECHO for monitoring of hemodynamics in stable neonates.
The current study enrolled 90 neonates, 40 males and 50 females with mean gestational age of 36.47 ± 2.17 SD weeks with mean weight of 2.57 ± 0.67 SD kg and mean length of 45.03 ± 3.36 SD cm. Their body surface area mean was 0.18 ± 0.03 SD m2. Echo and EC were both done simultaneously and within the first week of their lives. We compared 5 hemodynamic parameters that can be measured parallelly by EC and echo to detect both accuracy and correlation between the two devices in SV, CO, HR, CI and SI measurement.
Only hemodynamically stable neonates admitted during the study period with post-natal age less than or equal to 7 days were included.
Patients requiring any cardiac or respiratory support or who had any congenital cardiac anomalies, neonatal sepsis, or requiring surgery or those during their post operative care were excluded.
Electrical cardiometry was applied at the same setting of doing Echo after usual care and feeding of the baby.
In the current study, there was no statistically significant differences between EC and Echo measurements regarding SV, CO, HR, CI, and SI (P-value>0.05 for all parameters).
We detected a strong positive correlation between Echo and EC in all hemodynamic measurements (p-value<0.001 for all).
Considering the possible impact of gestational age, the current study showed that for both EC and Echo measurements, SV and CO were significantly higher in full term patients (p-value <0.005 for all).
For all measured parameters, there was no significant difference between EC and Echo measurements within the same gestational age (p-value ≥0.05 for all patients).
As per other parameters that could be measured by EC or echo, there was no difference between full term and preterm neonates except for TFC (by EC) which was higher in full term babies compared to preterms.
Consequently, and compared to echo, EC can be beneficial in measuring SV, CO, HR, SI and CI.