Pulmonary Peak Flow Assessment: An Easy Tool for Cardiac Output Estimation in Hemodynamically Stable Neonates

Area of Science:

• Neonatal Cardiology
• Pediatric Echocardiography
• Hemodynamics

Background:

• Assessing systemic blood flow (SBF) in neonates is crucial but often relies on right ventricular output (RVO) measurements, which demand specialized echocardiography skills.
• Pulmonary peak flow (PPF) presents a potential simpler alternative for estimating RVO and, consequently, SBF.

Purpose of the Study:

• To evaluate the correlation between RVO and PPF in term and preterm neonates.
• To assess the intraobserver variability of both RVO and PPF measurements.

Main Methods:

• A single-center, longitudinal, observational study included 33 neonates (term and preterm).
• Functional echocardiography scans were performed by an experienced neonatologist.
• Measurements were analyzed offline, with a repeat analysis after 12 months to determine intraobserver variability.

Main Results:

• A strong positive correlation was observed between RVO and PPF (p < 0.001).
• RVO exhibited a mean intra-observer difference of 34.2 mL/kg/min.
• PPF demonstrated a significantly lower mean intraobserver difference of 2.2 cm/s.

Conclusions:

• PPF is a viable surrogate for RVO in estimating cardiac output in neonates.
• The simplicity, speed, and low intraobserver variability of PPF make it a valuable tool for SBF assessment.
• Further research is recommended to explore PPF's correlation with other echocardiographic markers of diminished SBF.