Article ; Online: Electrical Cardiometry during transition and short-term outcome in very preterm infants: a prospective observational study.
European journal of pediatrics
2024 Volume 183, Issue 4, Page(s) 1629–1636
Abstract: The purpose of this study is to evaluate the association of Electrical Cardiometry (EC)-derived cardiac output indexed to weight (CO) and its changes during the first 48 h in relation to adverse short-term outcome in very preterm infants. In this ... ...
| Abstract | The purpose of this study is to evaluate the association of Electrical Cardiometry (EC)-derived cardiac output indexed to weight (CO) and its changes during the first 48 h in relation to adverse short-term outcome in very preterm infants. In this prospective observational study of preterm infants < 32 weeks gestational age (GA), the combined adverse outcome was defined as mortality or abnormal cranial ultrasound (any grade intracranial hemorrhage (ICH) or periventricular leukomalacia) within the first 2 weeks postnatally. Logistic regression models were used to investigate the association between median CO and outcome and mixed-effects models for the time trajectory of CO. In the absence of device-specific thresholds for low or high CO, no thresholds were used in our analysis. Fifty-three infants (median (IQR) GA 29.0 (25.4-30.6) weeks, birthweight 1020 (745-1505) g) were included in the analysis. Median CO was 241 (197-275) mL/kg/min for the adverse outcome and 198 (175-227) mL/kg/min for normal outcome (odds ratio (OR) (95% confidence interval (95% CI)), 1.01 (1.00 to 1.03); p = 0.028). After adjustment for GA, the difference was not significant (adjusted OR (95% CI), 1.01 (0.99 to 1.02); p = 0.373). CO trajectory did not differ by outcome (p = 0.352). A post hoc analysis revealed an association between CO time trajectory and ICH ≥ grade 2. Conclusions: EC-derived CO estimates within 48 h postnatally were not independently associated with brain injury (any grade) or mortality in the first 14 days of life. CO time trajectory was found to be associated with ICH ≥ grade 2. What is Known: • Bioreactance-derived cardiac output indexed to bodyweight (CO) in the transitional period has been associated with adverse short-term outcome in preterm infants. What is New: • Electrical Cardiometry (EC)-derived CO measurements in very preterm infants during the transitional period are not independently associated with adverse outcome (death or ultrasound detected brain damage) within 2 weeks postnatally. • In the first 48 h EC-derived CO increases over time and is higher in extremely preterm infants compared to very preterm and differs from previously reported bioreactance-derived CO values. |
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| MeSH term(s) | Female ; Humans ; Infant, Newborn ; Birth Weight ; Fetal Growth Retardation ; Gestational Age ; Infant, Extremely Premature ; Infant, Premature, Diseases/diagnosis ; Infant, Very Low Birth Weight ; Intracranial Hemorrhages |
| Language | English |
| Publishing date | 2024-01-08 |
| Publishing country | Germany |
| Document type | Observational Study ; Journal Article |
| ZDB-ID | 194196-3 |
| ISSN | 1432-1076 ; 0340-6199 ; 0943-9676 |
| ISSN (online) | 1432-1076 |
| ISSN | 0340-6199 ; 0943-9676 |
| DOI | 10.1007/s00431-023-05387-1 |
| Database | MEDical Literature Analysis and Retrieval System OnLINE |
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