Electrical cardiometry for early detection of hemodynamically significant patent ductus arteriosus in preterm infants.

OBJECTIVE

To determine whether early hemodynamic parameters measured using electrical cardiometry (EC) can be utilized for predicting hemodynamically significant patent ductus arteriosus (HS-PDA) in preterm neonates.

STUDY

DESIGN

This study involved 75 preterm neonates with gestational age (GA) ≤ 35 weeks who were admitted to a neonatal intensive care unit. Diagnosis of PDA was confirmed by echocardiography. All preterm neonates were continuously monitored since birth to assess their hemodynamic condition by measuring their oxygen saturation, mean arterial blood pressure, heart rate, and urinary output. All preterm neonates were connected to the EC on admission and after 12 h. Transthoracic two-dimensional echocardiography was performed 24 h after birth.

RESULTS

GA, birth weight, and Apgar score were substantially lower in neonates with HS-PDA than those with hemodynamically nonsignificant PDA. In addition, the cardiac output (CO) and stroke volume (SV) recorded by EC were significantly lower on admission and at 12 h (p < 0.01). CO and SV were significantly higher at 12 h compared with admission. Furthermore, echocardiography showed that the values of the left atrium to aortic root ratio, superior vena cava flow, right ventricular output, and left ventricular output were significantly elevated in neonates with HS-PDA than hemodynamically nonsignificant PDA. The receiver operator characteristic curve was analyzed to examine the capacity of the electrocardiometry parameters to predict HS-PDA. The area under the curve for CO was 0.751 and the cut-off point was ≤0.53 L/min, with sensitivity of 63.64 %, specificity of 78.57 %, positive predictive value of 70.0 %, and negative predictive value of 73.3 %.

CONCLUSION

EC could be beneficial for the early detection and monitoring of hemodynamic changes in high-risk neonates.