Is the new, noninvasive, continuous cardiorespiratory monitoring reliable during neonatal ECMO?

Research output: Contribution to journalArticle

Abstract

Background: Advances in cardiorespiratory monitoring have made the extracorporeal membrane oxygenation (ECMO) technique safer for the patient. Noninvasive, continuous tools are available, although data on their applications in the neonatal ECMO setting are lacking. Objective: We retrospectively described the neonatal clinical application of this continuous, noninvasive ECMO monitor and compared the analyzed parameters from those derived from blood gas analysis. Materials and methods: We performed 897 h of cardiorespiratory monitoring during neonatal venoarterial-ECMO (VA-ECMO) for four patients affected by (cardio-) respiratory failure, to compare the reliability of a noninvasive, continuous monitoring Spectrum M4® (M4) (Spectrum Medical, Gloucester, England) to an invasive, intermittent co-monitoring with blood gas analyzer (Radiometer Medical ApS, Brønshøj, Denmark). Results: A range of 117 pairs (time-matched BGA-derived vs. M4-derived parameters) was retrospectively analyzed. T-test, linear regression and Bland–Altman analysis for hemoglobin, hematocrit, venous oxygen saturation, oxygen delivery, oxygen consumption, oxygen extraction ratio, oxygen partial pressure, and carbon dioxide partial pressure showed a strong relationship between the two monitors for all parameters analyzed (p < 0.0001). Conclusions: Continuous, noninvasive cardiorespiratory monitoring appears to be feasible and reliable, although its accuracy needs to be verified in a more extensive cohort.

Original languageEnglish
Pages (from-to)638-645
JournalHeart and Lung
Volume47
Issue number6
DOIs
Publication statusPublished - 2018

Fingerprint

Extracorporeal Membrane Oxygenation
Oxygen
Partial Pressure
Blood Gas Analysis
Denmark
Hematocrit
Carbon Dioxide
Oxygen Consumption
Respiratory Insufficiency
England
Linear Models
Hemoglobins
Gases
Regression Analysis

Keywords

  • Cardiorespiratory monitoring
  • Neonatal ECMO
  • Noninvasive monitoring
  • Oxygenator performance
  • Respiratory failure

ASJC Scopus subject areas

  • Pulmonary and Respiratory Medicine
  • Critical Care and Intensive Care Medicine
  • Cardiology and Cardiovascular Medicine

Cite this

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title = "Is the new, noninvasive, continuous cardiorespiratory monitoring reliable during neonatal ECMO?",
abstract = "Background: Advances in cardiorespiratory monitoring have made the extracorporeal membrane oxygenation (ECMO) technique safer for the patient. Noninvasive, continuous tools are available, although data on their applications in the neonatal ECMO setting are lacking. Objective: We retrospectively described the neonatal clinical application of this continuous, noninvasive ECMO monitor and compared the analyzed parameters from those derived from blood gas analysis. Materials and methods: We performed 897 h of cardiorespiratory monitoring during neonatal venoarterial-ECMO (VA-ECMO) for four patients affected by (cardio-) respiratory failure, to compare the reliability of a noninvasive, continuous monitoring Spectrum M4{\circledR} (M4) (Spectrum Medical, Gloucester, England) to an invasive, intermittent co-monitoring with blood gas analyzer (Radiometer Medical ApS, Br{\o}nsh{\o}j, Denmark). Results: A range of 117 pairs (time-matched BGA-derived vs. M4-derived parameters) was retrospectively analyzed. T-test, linear regression and Bland–Altman analysis for hemoglobin, hematocrit, venous oxygen saturation, oxygen delivery, oxygen consumption, oxygen extraction ratio, oxygen partial pressure, and carbon dioxide partial pressure showed a strong relationship between the two monitors for all parameters analyzed (p < 0.0001). Conclusions: Continuous, noninvasive cardiorespiratory monitoring appears to be feasible and reliable, although its accuracy needs to be verified in a more extensive cohort.",
keywords = "Cardiorespiratory monitoring, Neonatal ECMO, Noninvasive monitoring, Oxygenator performance, Respiratory failure",
author = "Genny Raffaeli and Francesco Canesi and Federica Conigliaro and Stefano Ghirardello and Mara Vanzati and Chiara Baracetti and Monica Fumagalli and Fabrizio Ciralli and Federico Schena and Nicola Pesenti and Laura Plevani and Fabio Mosca and Giacomo Cavallaro",
year = "2018",
doi = "10.1016/j.hrtlng.2018.06.007",
language = "English",
volume = "47",
pages = "638--645",
journal = "Heart and Lung: Journal of Acute and Critical Care",
issn = "0147-9563",
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T1 - Is the new, noninvasive, continuous cardiorespiratory monitoring reliable during neonatal ECMO?

AU - Raffaeli, Genny

AU - Canesi, Francesco

AU - Conigliaro, Federica

AU - Ghirardello, Stefano

AU - Vanzati, Mara

AU - Baracetti, Chiara

AU - Fumagalli, Monica

AU - Ciralli, Fabrizio

AU - Schena, Federico

AU - Pesenti, Nicola

AU - Plevani, Laura

AU - Mosca, Fabio

AU - Cavallaro, Giacomo

PY - 2018

Y1 - 2018

N2 - Background: Advances in cardiorespiratory monitoring have made the extracorporeal membrane oxygenation (ECMO) technique safer for the patient. Noninvasive, continuous tools are available, although data on their applications in the neonatal ECMO setting are lacking. Objective: We retrospectively described the neonatal clinical application of this continuous, noninvasive ECMO monitor and compared the analyzed parameters from those derived from blood gas analysis. Materials and methods: We performed 897 h of cardiorespiratory monitoring during neonatal venoarterial-ECMO (VA-ECMO) for four patients affected by (cardio-) respiratory failure, to compare the reliability of a noninvasive, continuous monitoring Spectrum M4® (M4) (Spectrum Medical, Gloucester, England) to an invasive, intermittent co-monitoring with blood gas analyzer (Radiometer Medical ApS, Brønshøj, Denmark). Results: A range of 117 pairs (time-matched BGA-derived vs. M4-derived parameters) was retrospectively analyzed. T-test, linear regression and Bland–Altman analysis for hemoglobin, hematocrit, venous oxygen saturation, oxygen delivery, oxygen consumption, oxygen extraction ratio, oxygen partial pressure, and carbon dioxide partial pressure showed a strong relationship between the two monitors for all parameters analyzed (p < 0.0001). Conclusions: Continuous, noninvasive cardiorespiratory monitoring appears to be feasible and reliable, although its accuracy needs to be verified in a more extensive cohort.

AB - Background: Advances in cardiorespiratory monitoring have made the extracorporeal membrane oxygenation (ECMO) technique safer for the patient. Noninvasive, continuous tools are available, although data on their applications in the neonatal ECMO setting are lacking. Objective: We retrospectively described the neonatal clinical application of this continuous, noninvasive ECMO monitor and compared the analyzed parameters from those derived from blood gas analysis. Materials and methods: We performed 897 h of cardiorespiratory monitoring during neonatal venoarterial-ECMO (VA-ECMO) for four patients affected by (cardio-) respiratory failure, to compare the reliability of a noninvasive, continuous monitoring Spectrum M4® (M4) (Spectrum Medical, Gloucester, England) to an invasive, intermittent co-monitoring with blood gas analyzer (Radiometer Medical ApS, Brønshøj, Denmark). Results: A range of 117 pairs (time-matched BGA-derived vs. M4-derived parameters) was retrospectively analyzed. T-test, linear regression and Bland–Altman analysis for hemoglobin, hematocrit, venous oxygen saturation, oxygen delivery, oxygen consumption, oxygen extraction ratio, oxygen partial pressure, and carbon dioxide partial pressure showed a strong relationship between the two monitors for all parameters analyzed (p < 0.0001). Conclusions: Continuous, noninvasive cardiorespiratory monitoring appears to be feasible and reliable, although its accuracy needs to be verified in a more extensive cohort.

KW - Cardiorespiratory monitoring

KW - Neonatal ECMO

KW - Noninvasive monitoring

KW - Oxygenator performance

KW - Respiratory failure

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U2 - 10.1016/j.hrtlng.2018.06.007

DO - 10.1016/j.hrtlng.2018.06.007

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VL - 47

SP - 638

EP - 645

JO - Heart and Lung: Journal of Acute and Critical Care

JF - Heart and Lung: Journal of Acute and Critical Care

SN - 0147-9563

IS - 6

ER -