Written By: IJCP Editorial Team

Published On: 27 Feb, 2025 2:05 PM | Updated On: 01 Apr, 2025 3:14 AM

Non-Invasive Cardiac Output Monitoring in Neonatology Using Electrical Biosensing Technology

Non-invasive cardiac output monitoring utilizing electrical biosensing technology (EBT) allows for continuous monitoring of multi-parameter hemodynamic variables. EBT has the potential to detect hemodynamic instability in some neonates early, facilitating timely interventions that could enhance neonatal outcomes. It includes two methods: thoracic (TEBT) and whole body (WBEBT). Although these technologies are not as accurate as transthoracic echocardiography, their use in neonatology has significantly increased over the past 30 years, both in research and clinical settings. 

The European Society of Pediatric Research Special Interest Group in Non-Invasive Cardiac Output Monitoring, comprising experienced neonatologists, has provided guidance on TEBT and WBEBT usage in neonatology. While TEBT is not a reliable measure of cardiac output or stroke volume, it could be valuable for tracking changes in hemodynamic parameters over time. Recommendations for the use of TEBT in common neonatal conditions are limited, and WBEBT is not advised for cardiac output monitoring. Differences in the technologies, study designs, and data reporting need to be addressed in future research before incorporating EBT into standard practice.

Impact Statement:

- TEBT is not recommended as an reliable measure of cardiac output (CO) or stroke volume (SV).

- TEBT may be effective in monitoring individual patient changes in hemodynamic parameters over time.

- Changes in thoracic fluid content (TFC) from TEBT can help track progress in respiratory and circulatory conditions related to intrathoracic fluid volume.

- There is currently insufficient evidence to recommend WBEBT for CO monitoring in neonates.

- Additional research is necessary in all areas before these monitors can be routinely implemented in clinical practice.

Source: van Wyk L, Austin T, Barzilay B, Bravo MC, Breindahl M, Czernik C, Dempsey E, de Boode WP, de Vries W, Eriksen BH, Fauchére JC, Kooi EMW, Levy PT, McNamara PJ, Mitra S, Nestaas E, Rabe H, Rabi Y, Rogerson SR, Savoia M, Schena F, Sehgal A, Schwarz CE, Thome U, van Laere D, Zaharie GC, Gupta S; ESPR Special Interest Group on Non-Invasive Cardiac Output Monitoring. A recommendation for the use of electrical biosensing technology in neonatology. Pediatr Res. 2024 Jul 8. doi: 10.1038/s41390-024-03369-z. Epub ahead of print. Erratum in: Pediatr Res. 2024 Dec;96(7):1885. doi: 10.1038/s41390-024-03446-3. PMID: 38977797.