• Lizelle Van Wyk, Johan Smith, John Lawrenson, Carl J Lombard, and Willem-Pieter de Boode.
• Division Neonatology, Department of Paediatrics and Child Health, Stellenbosch University and Tygerberg Children's Hospital, Cape Town, South Africa.
• Neonatology. 2021 Jan 1; 118 (5): 600-608.

IntroductionIt is unknown whether bioreactance (BR) can accurately track cardiac output (CO) changes in preterm neonates.MethodsA prospective observational longitudinal study was performed in stable preterm infants (<37 weeks) during the first 72 h of life. Stroke volume (SV) and CO, as measured by BR and transthoracic echocardiography, were compared.ResultsThe mean gestational age (GA) was 31.3 weeks and mean birth weight (BW) was 1,563 g. Overall, 690 measurements were analysed for trending ability by 4-quadrant and polar plots. For non-weight-indexed measurements, 377 (54.6%) lay outside the 5% exclusion zone, the concordance rate was poor (77.2%) with a high mean angular bias (28.6°), wide limits of agreement and a poor angular concordance rate (17.4%). Neither GA, BW nor respiratory support mode affected trending data. Patent ductus arteriosus, postnatal age, and CO level had variable effects on trending data. Trending data for 5 and 10% exclusion zones were also compared.ConclusionThe ability of BR to track changes in CO is not interchangeable with CO changes as measured by echocardiography. BR, as a trend monitor for changes in CO or SV to determine clinical decisions around interventions in neonatology, should be used with caution.© 2021 S. Karger AG, Basel.

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