Forman E, et al. – The feasibility and reliability of noninvasive cardiac output monitoring (NICOM) and near–infrared spectroscopy (NIRS) were examined in term infants with neonatal encephalopathy (NE). Outcomes confirmed that noninvasive hemodynamic assessment of infants with NE was feasible as well as it displayed potentially important changes. However, more likewise studies were required to evaluate the clinical applicability of these methods in this population.

Methods

• During therapeutic hypothermia (TH) and rewarming, NICOM and NIRS were commenced to measure cardiac output (CO), systemic vascular resistance (SVR), blood pressure (BP), and cerebral regional oxygen saturations (SctO₂).
• NICOM measures of CO were also compared with simultaneous echocardiography–derived CO (echo–CO).

Results

• This study included 20 infants with a median gestation of 40 weeks.
• A strong correlation between NICOM– and echo–CO was reported (r²=0.79, P<0.001).
• NICOM–CO was systematically lower than echo–CO with a bias of 27%(limits of agreement 3–51%).
• NICOM illustrated lower CO during TH, which increased during rewarming.
• SctO₂ increased over the first 30 h of TH and stayed high for the remainder of the study.
• There was a rise in SVR over the first 30 h of TH and a decrease during rewarming (all P<0.05).