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Background Evaluation of cardiac output in neonates might be difficult because of the complexity and risks of invasive classical procedures. New systems like electrical cardiometry (EC: Osypka Medical, Berlin, Germany and La Jolla, California, USA) have been proposed but few data are available in neonates. We investigated stroke volume (SV) using EC in term and preterm infants. Methods Eligible patients were neonates admitted to the NICU and undergoing echocardiography for any clinical reasons, without congenital heart disease. We measured SV with EC and echocardiography, within 10 min. Measurements were repeated 6 times by the same operator to calculate repeatability before and after echocardiography. Data have been compared with correlation and Bland-Altman analysis. Results 59 neonates were enrolled, allowing 150 paired measurements. Mean gestational age and birth weight were 33.9 ± 3.4 wks and 1988 ± 823 g, respectively. Results of Pearson correlation and Bland-Altman analysis for the whole population were (r = 0.611; p Correlation is maintained even with PDA (r = 0.627; p Gestational age seems to do not influence the correlation between EC and echo (Partial correlation coefficient r = 0.36; p Repeatability (coefficient of variation) was 46% for EC and 52% for echocardiography. There was no difference in SV measured by EC after 10 min (3.76 ± SD vs 3.78 ± SD; p = 0.56, Wilcoxon test). Conclusions EC is feasible, reproducible and quick. It could be an useful tool for continuous monitoring and haemodynamic evaluation in neonates. EC is particularly interesting for the clinical management of preterm neonates.

Background Electrical cardiometry (EC: Osypka Medical, Berlin, Germany and La Jolla, California, USA) is a new non-invasive technique for haemodynamic monitoring of neonates. No data are available for preterm babies during respiratory procedures, such as elective extubation or chest physiotherapy. We designed this study to clarify if these procedures have any haemodynamic consequences. Methods We assessed stroke volume (SV), cardiac output (CO), contractility index (ICON) and heart rate (HR) with EC before and after 5, 10, 15, 30 and 60 min from elective extubation or physiotherapy sessions with accelerated expiratory flow [Demont B et al , Physiotherapy 2007;93:12–16]. Functional echocardiography has been performed by the same operator before and after 60 min from the above-described respiratory procedures. Infants with congenital heart disease were not eligible. Results Eleven (for physiotherapy) and thirteen (for extubation) preterm infants were enrolled. Gestational age and birth weight were 29.2 ± 0.5 wks and 1313 ± 915 g, respectively. Fig.1 shows trends of SV, CO, ICON and HR before and after the procedures: no differences were noticed (p = 0.318 for SV; p = 0.559 for CO; p = 0.23 for ICON;p = 0.78 for HR, Friedman test). No differences were found analysing separately extubation and physiotherapy groups. Conclusions No haemodynamic changes are visible during elective extubation or chest physiotherapy in preterm infants. These preliminary results deserve further evaluation studying cerebral oxygenation with NIRS.

Introduction Regionalization in perinatal care improved neonatal survival for 2 decades. Perinatal transport is known to be a bad prognostic factor for preterm neonates born in second level centres. No data exist for babies born in TCC who had to be transferred to other TTC. We evaluate short term clinical outcomes of preterm infants transferred between TCC. Methods We retrospectively analysed all neonates aged ≤32 weeks gestation transferred before 6 h of life from the South Paris University Hospitals to another TCC. Transfer was due to organisational problems. Control group consisted of neonates born the month before or after the cases and matched for gestational age, birth weight and CRIB-II. Simple linear and logistic regressions were used for analysis. Results We included 60 cases and 60 controls. The two groups were similar for basic clinical characteristics. No difference in clinical features (RDS, infection related respiratory failure, air leaks, hypotension) were present between the groups (Table 1). Early outcomes (IVH, periventricular leucomalacy, NEC, BPD and NICU stay) rates were not influenced by the transfer transport ((Table 1) Conclusions Perinatal transfer for preterm babies born in a TCC is not a negative prognostic factor. It is conceivable that optimal care in delivery room is a keystone for better outcome.