Accuracy and precision of ultrasonic cardiac output monitor versus echocardiography for cardiac output measurement in neonates: a systematic review and meta-analysis

Abstract

Aim: To perform a systematic review and meta-analysis of the consistency between ultrasonic cardiac output monitor (USCOM) and echocardiography in monitoring neonatal cardiac output.

Material and methods: PubMed, Embase, Web of Science, Cochrane, Wanfang, Chinese National Knowledge Infrastructure Database, and Chinese Science and Technique Journal Database were searched from the inception of the databases to November 2024. Two reviewers independently performed study selection, data extraction, and risk of bias assessment. Method-comparison studies evaluating USCOM versus echocardiography in neonates were included. Pooled mean bias (accuracy), standard deviation, and mean percentage error (precision) of the included studies were calculated using a fixed-effects model.

Results: Six of the 774 identified studies were included in the qualitative analysis, and four studies were included in the meta-analysis. The overall pooled bias and percentage error for left ventricular output measurements were -7.7±13.5 mL/kg/min (95% limit of agreement: -34.2 to 18.8 mL/kg/min) and 31.2%, respectively, while the overall pooled bias and percentage error for right ventricular output measurements were 40.5±21.3 mL/kg/min (95% limit of agreement: -1.2 to 82.2 mL/kg/min) and 35.1%, respectively.

Conclusion: USCOM may overestimate right ventricular output trend, while left ventricular output measurement agreement is slightly better.