{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,7,30]],"date-time":"2025-07-30T16:12:22Z","timestamp":1753891942785,"version":"3.41.2"},"reference-count":32,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2022,2,25]],"date-time":"2022-02-25T00:00:00Z","timestamp":1645747200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Pediatr."],"abstract":"<jats:sec><jats:title>Objectives<\/jats:title><jats:p>Impedance cardiography (ICG) is a non-invasive method for continuous cardiac output measurement and has the potential to improve monitoring and treatment of sick neonates. PhysioFlow<jats:sup>\u00ae<\/jats:sup> is a signal-morphology ICG-system showing promising results in adults with low and high cardiac output, but no data from neonates or neonatal models exist. The aim of this study was to investigate PhysioFlow<jats:sup>\u00ae<\/jats:sup> feasibility in asphyxiated newborn piglets.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Fifteen piglets, under continuous arterial heart rate (HR) and blood pressure (BP) monitoring, were asphyxiated until asystole. Cardiopulmonary resuscitation was performed and the piglets monitored after return of spontaneous circulation (ROSC). Arterial lactate was measured at baseline, every 5 min throughout asphyxiation, at asystole, and at 10 min and later every 30 min after ROSC. PhysioFlow<jats:sup>\u00ae<\/jats:sup> measured cardiac stroke volume (SV) and HR, and calculated cardiac index (CI) (L\/m<jats:sup>2<\/jats:sup>\/min). Registrations with a signal quality &amp;lt; 75% were excluded, and registrations recorded for 30 min from start of asphyxia analyzed. Pearson correlations were calculated for CI; and HR, mean BP and blood lactate.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>The piglets were asphyxiated for median (interquartile range) 30 (20\u201335) min and had a lactate at asystole of 15.0 (9.1\u201317.0) mmol\/L. Out of a total of 20.991 registrations in all animals combined, there were 10.148 (48.3%) registrations with a signal quality \u2265 75%. Signal quality \u2265 75% varied in individual piglets from 7 to 82% of registrations. We analyzed 1.254 registrations recorded 30 min from initiation of asphyxia, i.e., in piglets with brief asphyxia times, this included cardiopulmonary resuscitation and post-ROSC observation. There was a positive correlation between CI and SVI (<jats:italic>r<\/jats:italic> = 0.90, <jats:italic>p<\/jats:italic> &amp;lt; 0.001), and between CI and HR (<jats:italic>r<\/jats:italic> = 0.446, <jats:italic>p<\/jats:italic> &amp;lt; 0.001). There was no correlation between CI, or mean BP or lactate (<jats:italic>p<\/jats:italic> = 0.98 and 0.51, respectively).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>About half of ICG-registrations in asphyxiated piglets were of good quality. However, signal quality was highly variable between piglets. In total, there was a higher proportion of reliable ICG-registrations than reported from clinical delivery room studies using electrical velocimetry. Our data are physiologically plausible and supports further research evaluating PhysioFlow<jats:sup>\u00ae<\/jats:sup> for cardiac output monitoring in perinatal asphyxia. In particular, factors influencing inter-individual variations in signal quality should be explored.<\/jats:p><\/jats:sec>","DOI":"10.3389\/fped.2022.804353","type":"journal-article","created":{"date-parts":[[2022,2,25]],"date-time":"2022-02-25T05:54:15Z","timestamp":1645768455000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":1,"title":["Neonatal Impedance Cardiography in Asphyxiated Piglets\u2014A Feasibility Study"],"prefix":"10.3389","volume":"10","author":[{"given":"Gazmend","family":"Berisha","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"R\u00f8nnaug","family":"Solberg","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Claus","family":"Klingenberg","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Anne Lee","family":"Solev\u00e5g","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1965","published-online":{"date-parts":[[2022,2,25]]},"reference":[{"key":"B1","doi-asserted-by":"publisher","first-page":"506","DOI":"10.1016\/S0022-3476(96)70114-2","article-title":"Relationship between blood pressure and cardiac output in preterm infants requiring mechanical ventilation","volume":"129","author":"Kluckow","year":"1996","journal-title":"J Pediatr."},{"key":"B2","doi-asserted-by":"publisher","first-page":"F168","DOI":"10.1136\/adc.2002.023796","article-title":"Clinical detection of low upper body blood flow in very premature infants using blood pressure, capillary refill time, and central-peripheral temperature difference","volume":"89","author":"Osborn","year":"2004","journal-title":"Arch Dis Child Fetal Neonatal Ed."},{"key":"B3","doi-asserted-by":"publisher","first-page":"550","DOI":"10.1136\/adc.47.254.550","article-title":"Serial determinations of blood lactate in respiratory distress syndrome","volume":"47","author":"Beca","year":"1972","journal-title":"Arch Dis Child."},{"key":"B4","doi-asserted-by":"publisher","first-page":"F15","DOI":"10.1136\/fn.76.1.F15","article-title":"Association between blood lactate and acid-base status and mortality in ventilated babies","volume":"76","author":"Deshpande","year":"1997","journal-title":"Arch Dis Child Fetal Neonatal Ed."},{"key":"B5","doi-asserted-by":"publisher","first-page":"e0213537","DOI":"10.1371\/journal.pone.0213537","article-title":"Lactate acidosis and cardiac output during initial therapeutic cooling in asphyxiated newborn infants","volume":"14","author":"Eriksen","year":"2019","journal-title":"PLoS ONE."},{"key":"B6","doi-asserted-by":"publisher","first-page":"e48","DOI":"10.1055\/s-0035-1565921","article-title":"Secondary increase of lactate levels in asphyxiated newborns during hypothermia treatment: reflect of suboptimal hemodynamics (a case series and review of the literature)","volume":"6","author":"Al Balushi","year":"2016","journal-title":"AJP Rep."},{"key":"B7","doi-asserted-by":"publisher","first-page":"851","DOI":"10.1111\/j.1365-2044.2008.05495.x","article-title":"Comparison of cardiac output measurement using the CardioQP oesophageal Doppler with cardiac output measurement using thermodilution technique in children during heart catheterisation","volume":"63","author":"Knirsch","year":"2008","journal-title":"Anaesthesia."},{"key":"B8","doi-asserted-by":"publisher","first-page":"1180","DOI":"10.1213\/ANE.0b013e3181f08a5b","article-title":"A critical review of the ability of continuous cardiac output monitors to measure trends in cardiac output","volume":"111","author":"Critchley","year":"2010","journal-title":"Anesth Analg."},{"key":"B9","doi-asserted-by":"publisher","first-page":"889","DOI":"10.1001\/jama.276.11.889","article-title":"The effectiveness of right heart catheterization in the initial care of critically ill patients. 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