TY - JOUR
T1 - Clinical validation of bioreactance for the measurement of cardiac output in pregnancy
AU - Ling, H. Z.
AU - Gallardo-Arozena, M.
AU - Company-Calabuig, A. M.
AU - Nicolaides, K. H.
AU - Kametas, N. A.
PY - 2020/10/1
Y1 - 2020/10/1
N2 - Maternal cardiac dysfunction is associated with pre-eclampsia, fetal growth restriction and haemodynamic instability during obstetric anaesthesia. There is growing interest in the use of non-invasive cardiac output monitoring to guide antihypertensive and fluid therapies in obstetrics. The aim of this study was to validate thoracic bioreactance using the NICOM® instrument against transthoracic echocardiography in pregnant women, and to assess the effects of maternal characteristics on the absolute difference of stroke volume, cardiac output and heart rate. We performed a prospective study involving women with singleton pregnancies in each trimester. We recruited 56 women who were between 11 and 14 weeks gestation, 57 between 20 and 23 weeks, and 53 between 35 and 37 weeks. Cardiac output was assessed repeatedly and simultaneously over 5 min in the left lateral position with NICOM and echocardiography. The performance of NICOM was assessed by calculating bias, 95% limits of agreement and mean percentage difference relative to echocardiography. Multivariate regression analysis evaluated the effect of maternal characteristics on the absolute difference between echocardiography and NICOM. The mean percentage difference of cardiac output measurements between the two methods was ±17%, with mean bias of −0.13 l.min−1 and limits of agreement of −1.1 to 0.84; stroke volume measurements had a mean percentage difference of ±15%, with a mean bias of −0.8 ml (−10.9 to 12.6); and heart rate measurements had a mean percentage difference of ±6%, with a mean bias of −2.4 beats.min−1 (−6.9 to 2.0). Similar results were found when the analyses were confined to each individual trimester. The absolute difference between NICOM and echocardiography was not affected by maternal age, weight, height, race, systolic or diastolic blood pressure. In conclusion, NICOM demonstrated good agreement with echocardiography, and can be used in pregnancy for the measurement of cardiac function.
AB - Maternal cardiac dysfunction is associated with pre-eclampsia, fetal growth restriction and haemodynamic instability during obstetric anaesthesia. There is growing interest in the use of non-invasive cardiac output monitoring to guide antihypertensive and fluid therapies in obstetrics. The aim of this study was to validate thoracic bioreactance using the NICOM® instrument against transthoracic echocardiography in pregnant women, and to assess the effects of maternal characteristics on the absolute difference of stroke volume, cardiac output and heart rate. We performed a prospective study involving women with singleton pregnancies in each trimester. We recruited 56 women who were between 11 and 14 weeks gestation, 57 between 20 and 23 weeks, and 53 between 35 and 37 weeks. Cardiac output was assessed repeatedly and simultaneously over 5 min in the left lateral position with NICOM and echocardiography. The performance of NICOM was assessed by calculating bias, 95% limits of agreement and mean percentage difference relative to echocardiography. Multivariate regression analysis evaluated the effect of maternal characteristics on the absolute difference between echocardiography and NICOM. The mean percentage difference of cardiac output measurements between the two methods was ±17%, with mean bias of −0.13 l.min−1 and limits of agreement of −1.1 to 0.84; stroke volume measurements had a mean percentage difference of ±15%, with a mean bias of −0.8 ml (−10.9 to 12.6); and heart rate measurements had a mean percentage difference of ±6%, with a mean bias of −2.4 beats.min−1 (−6.9 to 2.0). Similar results were found when the analyses were confined to each individual trimester. The absolute difference between NICOM and echocardiography was not affected by maternal age, weight, height, race, systolic or diastolic blood pressure. In conclusion, NICOM demonstrated good agreement with echocardiography, and can be used in pregnancy for the measurement of cardiac function.
KW - bioreactance
KW - cardiac function
KW - cardiac output
KW - Doppler echocardiography
KW - haemodynamics
KW - pre-eclampsia
KW - stroke volume
UR - http://www.scopus.com/inward/record.url?scp=85085551980&partnerID=8YFLogxK
U2 - 10.1111/anae.15110
DO - 10.1111/anae.15110
M3 - Article
C2 - 32469423
AN - SCOPUS:85085551980
SN - 1365-2044
VL - 75
SP - 1307
EP - 1313
JO - Anaesthesia
JF - Anaesthesia
IS - 10
ER -