Research Progress of Noninvasive Cardiac Output Monitor (NICOTM) and Hemodynamic Monitor in Neonates
Open accessAbstract
Objective: Hemodynamic monitoring plays a crucial way in guiding the clinical decision-making process for the management of critically ill neonates. Noninvasive hemodynamic monitoring is characterized by continuous, convenient, and accurate assessment, presenting a viable option for implementation in neonatal intensive care units (NICU). This review article summarizes the research advancements made in noninvasive hemodynamic monitoring and electronic cardiometry (EC) applications in neonates, providing valuable reference resource for studies in the field of hemodynamic monitoring. Mechanism: The clinical significance of hemodynamic monitoring in neonates is first introduced and followed by a comprehensive description of both invasive and noninvasive techniques employed in hemodynamic monitoring. Furthermore, the research progress of EC in neonates is discussed, focusing particularly on its feasibility and accuracy. Finally, the application and influencing factors of EC in diverse diseases, encompassing neonatal conditions, are presented. Findings in Brief: Due to the risks associated with invasive cardiac output monitoring, noninvasive or minimally invasive alternative techniques are needed for hemodynamic monitoring. In recent years, noninvasive and minimally invasive techniques, such as ultrasound cardiac output monitor (USCOM) and impedance cardiography have been utilized. EC, as an impedance-based monitoring, facilitates noninvasive and real-time assessment of hemodynamic parameters. The integration of EC enables real-time and continuous monitoring of dynamic changes in cardiac and vascular functions in patients, thereby assisting in clinical evaluation and guiding the clinical decision-making. Conclusion: EC is a noninvasive, highly sensitive, and accurate monitoring technique that holds important guiding significance in clinical practice.
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EC has shown strong agreement with transthoracic echocardiography regarding stroke volume, stroke volume variation, and the inferior vena cava distensibility index.
“Moreover, EC has shown strong agreement with transthoracic echocardiography regarding stroke volume, stroke volume variation (SVV), and the inferior vena cava distensibility index (dIVC) [71].”
From Trends and Challenges in Noninvasive Hemodynamic Monitoring of Neonates Following Cardiac Surgery: A Narrative Review (2025) · cites this paper as [71]
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Cites
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“[31] have found through meta-analysis that ECG cannot replace thermodilution and TTE to measure absolute CO.”
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“[24] showed that EC is comparable to the aortic flow-based TTE method for pediatric patients.”
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“[25,26] showed that EC method is feasible, reproducible, fast, and it is a useful tool for continuous monitoring, and hemodynamic evaluation of neonates.”
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“[28] have found that EC and Doppler TTE have good consistency in estimating SV, and they are interchangeable.”
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“[23] evaluate the practicability of EC monitoring by comparing the results of CO and system blood flow, measured by EC and echocardiography (ECHO).”
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“[33] reported that a total of 280 neonates are studied and the results indicate that CO is positively correlated with gestational age, body weight and body surface area (r = 0.681, 0.822, 0.830; all p 0.001).”
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“[22] compared SV and HR of 228 premature infants with transthoracic echocardiography (TTE) (134 LBW, 94 VLBW) and EC (134 LBW, 94 VLBW) by bland-Altman diagram.”
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Prone positioning decreases cardiac output and increases systemic vascular resistance in neonates
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“[20] have also used EC in the delivery room to monitor the first 15 minutes of the life of full-term infants.”
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“However, it is difficult to be promoted in wards because of continuous detection and expensive equipment [16].”
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“[40] include 96 neonates with gestational age of 37.9 ± 2.6 weeks in the study.”
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“[46] used EC (Electrocardiogram) and ECHO (Echocardiography) techniques to confirm that in healthy full-term infants, the decrease in cardiac output (CO) in the prone position is due to a reduction in stroke volume (SV) rather than heart rate (HR) decrease.”
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“[44] have found that normal neonatal CO is stable within 0.5~6 hours after birth, and infants with perinatal asphyxia have lower CO before and during treat-ment.”
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“The first category is the invasive CO monitoring techniques, including traditional hot dilution method, pulmonary artery floating catheter and direct Fick law [12].”
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“A floating catheter is inserted into the subclavian vein, and CO and other hemodynamic indicators are calculated by tracing the area under the time-temperature curve [14].”
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“[25,26] showed that EC method is feasible, reproducible, fast, and it is a useful tool for continuous monitoring, and hemodynamic evaluation of neonates.”
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“[47] used the EC technique to compare left and supine positions, indicating that SV and CO were reduced.”
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Flagged first, then by citations
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Fatoni, A., Anggraeni, M. D., & Rahmawati, E. (2025) · Analytica—A Journal of Analytical Chemistry and Chemical Analysis · doi:10.3390/analytica6010006 · Cited by 4 · see citing works
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“Moreover, EC has shown strong agreement with transthoracic echocardiography regarding stroke volume, stroke volume variation (SVV), and the inferior vena cava distensibility index (dIVC) [71].”
- Authors
- Li, F., & Dong, W.
- Affiliations
- Affiliated Hospital of Southwest Medical University (CN)
- Corresponding author
- Li, Fengying
- Dong, Wenbin
- Venue
- Clinical and Experimental Obstetrics & Gynecology
- Publisher
- IMR Press
- Published
- 2023-10-12
- Volume
- 50
- Issue
- 10
- ISSN
- 0390-6663 (ISSN-L)
- 2709-0094
- OpenAlex
- W4387609935
- Cited by
- 2
- References
- 44
- Citations by year
- 2025: 2
- FWCI
- 0.54
- Type
- journal article
- Language
- en
- Open access
- gold
- doi.org
- Locations
- Clinical and Experimental Obstetrics & Gynecology (publishedVersion, cc-by)
- DOAJ (DOAJ: Directory of Open Access Journals) (submittedVersion, cc-by-sa)
- Topics
- Health Sciences › Medicine › Surgery › Hemodynamic Monitoring and Therapy
- Physical Sciences › Engineering › Biomedical Engineering › Non-Invasive Vital Sign Monitoring
- Health Sciences › Medicine › Surgery › Healthcare Technology and Patient Monitoring
- Keywords
- noninvasive hemodynamic monitoring, neonates, impedance cardiography, cardiac output monitoring, neonatal intensive care, invasive hemodynamic monitoring, critically ill neonates
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