Maintaining optimal circulatory status is a key component of preterm neonatal care. Low-cardiac output (CO) in the preterm neonate leads to inadequate perfusion of vital organs and has been linked to a variety of adverse outcomes with heightened acute morbidity and mortality and adverse neurodevelopmental outcomes. Having technology available to monitor CO allows us to detect low-output states and potentially intervene to mitigate the unwanted effects of reduced organ perfusion. There are many technologies available for the monitoring of CO in the preterm neonatal population and while many act as useful adjuncts to aid clinical decision-making no technique is perfect. In this review, we discuss the relative merits and limitations of various common methodologies available for monitoring CO in the preterm neonatal population. We will discuss the ongoing challenges in monitoring CO in the preterm neonate along with current gaps in our knowledge. We conclude by discussing emerging technologies and areas that warrant further study.

Neonatology Department Coombe Women and Infant University Hospital Dublin Ireland Department of Paediatrics Trinity College Dublin National Children's Hospital Tallaght Dublin Ireland

Neonatology Department Coombe Women and Infant University Hospital Dublin Ireland Institute for the Care of Mother and Child Prague Czechia 3rd School of Medicine Charles University Prague Czechia UCD School of Medicine and Medical Sciences Dublin Ireland

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