Advanced Hemodynamic Monitoring in the Neonatal Intensive Care Unit
Open accessAbstract
Clinical assessment of cardiac output by interpretation of indirect parameters has proven to be inaccurate, irrespective of the level of experience of the clinician. Objective cardiac output monitoring is feasible in newborn infants in intensive care. The most promising methods include transthoracic echocardiography, transcutaneous Doppler, electrical biosensing technologies, transpulmonary ultrasound dilution, and arterial pulse contour analysis. Simultaneous assessment of blood pressure and cardiac output enables the identification of the earliest stage of shock. Comprehensive hemodynamic monitoring is pivotal for an individualized pathophysiology-based hemodynamic management.
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Echocardiography shows a precision error of around 30% when compared to gold standard dilution techniques, which falls within the clinically accepted range.
“For instance, echocardiography shows a precision error of around 30% when compared to gold standard dilution techniques, which falls within the clinically accepted range [54,55].”
From Trends and Challenges in Noninvasive Hemodynamic Monitoring of Neonates Following Cardiac Surgery: A Narrative Review (2025) · cites this paper as [54]
The Transthoracic Echocardiography section reports an error of around ±30% relative to more accurate reference methods, including dye dilution and thermodilution. It does not call that error clinically acceptable; instead, it describes echocardiography's precision as limited and cautions against using it as a reference method. (LLM, conf=0.90)
Experimental — accuracy not yet measuredIn neonates without shunting, echocardiographic measurement of cardiac output is generally reliable, with values ranging between 150 and 300 mL/kg/min.
“In neonates without shunting, echocardiographic measurement of cardiac output is generally reliable, with values ranging between 150 and 300 mL/kg/min [53,54].”
From Trends and Challenges in Noninvasive Hemodynamic Monitoring of Neonates Following Cardiac Surgery: A Narrative Review (2025) · cites this paper as [54]
The 'What Is a Normal Level of Cardiac Output?' section gives 150–300 mL/kg/min as normal ventricular output in (pre)term infants without transductal or interatrial shunting. But the 'Transthoracic Echocardiography' section describes limited accuracy and precision, with error around ±30%, so it does not support calling echocardiographic measurement generally reliable. (LLM, conf=0.89)
Experimental — accuracy not yet measuredTCD has poor agreement to other cardiac output monitoring techniques, including TTE and thermodilution, with a bias ranging from 0% to 21% and an error margin between 43 and 65%.
“It has poor agreement to other cardiac output monitoring techniques, including TTE and thermodilution, with a bias ranging from 0% to 21% and an error margin between 43 and 65%, respectively [54].”
From Trends and Challenges in Noninvasive Hemodynamic Monitoring of Neonates Following Cardiac Surgery: A Narrative Review (2025) · cites this paper as [54]
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ОСОБЕННОСТИ МИКРОЦИРКУЛЯЦИИ У НЕДОНОШЕННЫХ ДЕТЕЙ С НИЗКОЙ МАССОЙ ТЕЛА ПРИ РОЖДЕНИИ
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- Authors
- de Boode, W.-P.
- Venue
- Clinics in Perinatology
- Publisher
- Elsevier BV
- Published
- 2020-09
- Volume
- 47
- Issue
- 3
- Pages
- 423-434
- ISSN
- 0095-5108 (ISSN-L)
- OpenAlex
- W3026122157
- Cited by
- 34
- References
- 43
- Citations by year
- 2026: 4 · 2025: 7 · 2024: 5 · 2023: 6 · 2022: 5 · 2021: 5 · 2020: 1
- FWCI
- 0.96
- Type
- journal article
- Language
- en
- Open access
- hybrid
- doi.org
- Licence
- Locations
- Clinics in Perinatology (publishedVersion, cc-by)
- PubMed (publishedVersion)
- Funders
- Transonic Systems Inc
- Pulsion Medical Systems
- Osypka Medical
- Cheetah Medical Inc
- NI Medical
- Topics
- Health Sciences › Medicine › Surgery › Hemodynamic Monitoring and Therapy
- Health Sciences › Medicine › Epidemiology › Sepsis Diagnosis and Treatment
- Health Sciences › Medicine › Epidemiology › Congenital Heart Disease Studies
- Keywords
- hemodynamic monitoring, cardiac output, neonatal intensive care, neonates, transthoracic echocardiography, electrical biosensing, arterial pulse contour analysis, shock detection, blood pressure, hemodynamic management
- MeSH terms
- Hemodynamic Monitoring, Blood Flow Velocity, Blood Gas Analysis, Blood Pressure, Blood Pressure Determination, Cardiac Output, Echocardiography, Humans, Infant, Newborn, Intensive Care Units, Neonatal, Reference Values, Shock, Biosensing Techniques, Critical Illness, Ultrasonography, Doppler, Pulse Wave Analysis
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