Myocardial function in late preterm infants during the transitional period: comprehensive appraisal with deformation mechanics and non-invasive cardiac output monitoring

2019 ◽  
Vol 30 (2) ◽  
pp. 249-255
Author(s):  
Alessia Cappelleri ◽  
Neidin Bussmann ◽  
Susan Harvey ◽  
Phillip T. Levy ◽  
Orla Franklin ◽  
...  
Keyword(s):  
Cardiac Output ◽  
Stroke Volume ◽  
Preterm Infants ◽  
Left Ventricular ◽  
Late Preterm ◽  
Cardiac Output Monitoring ◽  
Late Preterm Infants ◽  
Non Invasive ◽  
Left Ventricular Output ◽  
Output Monitoring

AbstractBackground:There is a paucity of functional data on mid-to-late preterm infants between 30+0 and 34+6 weeks gestation. We aimed to characterise transitional cardiopulmonary and haemodynamic changes during the first 48 hours in asymptomatic mid-to-late preterm infants.Methods:Forty-five healthy preterm newborns (mean ± standard deviation) gestation of 32.7 ± 1.2 weeks) underwent echocardiography on Days 1 and 2. Ventricular mechanics were assessed by speckle tracking-derived deformation, rotational mechanics, tissue Doppler imaging, and right ventricle-focused measures (tricuspid annular plane systolic excursion, fractional area change). Continuous haemodynamics were assessed using the NICOM™ system to obtain left ventricular output, stroke volume, heart rate, and total peripheral resistance by non-invasive cardiac output monitoring.Results:Right ventricular function increased (all measures p < 0.005) with mostly stable left ventricular performance between Day 1 and Day 2. NICOM-derived left ventricular output [mean 34%, 95% confidence interval 21–47%] and stroke volume [29%, 16–42%] increased with no change in heart rate [5%, −2 to 12%]. There was a rise in mean blood pressure [11%, 1–21%], but a decline in total peripheral resistance [−14%, −25 to −3%].Conclusion:Left ventricular mechanics remained persevered in mid-to-late premature infants, but right ventricular function increased. Non-invasive cardiac output monitoring is feasible in preterm infants with an increase in left ventricular output driven by an improvement in stroke volume during the transitional period.

Agreement of Cardiac Output Measurements between Bioreactance and Transthoracic Echocardiography in Preterm Infants during the Transitional Phase: A Single-Centre, Prospective Study

Neonatology ◽  
2020 ◽  
Vol 117 (3) ◽  
pp. 271-278 ◽  
Author(s):  
Lizelle Van Wyk ◽  
Johan Smith ◽  
John Lawrenson ◽  
Willem Pieter de Boode
Keyword(s):  
Cardiac Output ◽  
Preterm Infants ◽  
Transthoracic Echocardiography ◽  
Ductus Arteriosus ◽  
Left Ventricular ◽  
Percentage Error ◽  
Preterm Neonates ◽  
Non Invasive ◽  
Left Ventricular Output ◽  
Transitional Phase

<b><i>Introduction:</i></b> Bioreactance cardiac output (CO) monitors are able to non-invasively and continuously monitor CO. However, as a novel tool to measure CO, it must be proven to be accurate and precise. <b><i>Objective:</i></b> To determine the agreement between CO measured with a bioreactance monitor and transthoracic echocardiography-derived left ventricular output parameters in preterm infants. <b><i>Methods:</i></b> This is a prospective observational study in 63 preterm neonates with non-invasive respiratory support, not requiring inotrope support. The infants underwent continuous bioreactance monitoring of CO and stroke volume (SV) and simultaneous transthoracic echocardiography every 6 h until 72 h of life. <b><i>Results:</i></b> The agreement between bioreactance and transthoracic echocardiography, for both SV and CO, was poor. The percentage error was 67.5% for SV and 71.6% for CO. The mean error was 60.4% for SV and 69.8% for CO. Bias was affected by numerous variables. After correcting for time, CO and SV bias were significantly affected by the presence of an open patent ductus arteriosus and the level of CO. <b><i>Conclusion:</i></b> Bioreactance cannot be considered interchangeable with transthoracic echocardiography to measure CO in preterm infants during the transition phase. Agreement between bioreactance and other CO metrics should be assessed before concluding its accuracy or inaccuracy in neonates.

scholarly journals Correlation between Perfusion Index and Left Ventricular Output in Healthy Late Preterm Infants

2021 ◽  
Author(s):  
Nilay Hakan ◽  
Ayça Aytekin ◽  
Özkan İlhan ◽  
Mustafa Aydin ◽  
Haşim Olgun
Keyword(s):  
Preterm Infants ◽  
Left Ventricular ◽  
Perfusion Index ◽  
Late Preterm ◽  
Microvascular Blood Flow ◽  
Systemic Hemodynamic ◽  
Late Preterm Infants ◽  
Preterm Babies ◽  
Left Ventricular Output ◽  
The Mean

Abstract The perfusion index (PI) is a noninvasive marker derived from photoelectric plethysmographic signals in pulse oximetry in the evaluation of peripheral perfusion. This study was aimed to determine the correlation between PI and left ventricular output (LVO) in healthy late preterm infants at 48th hour of life. With new generation pulse oximeter [MASIMO Rad 7 Oximeter] pre- and post-ductal PI values were recorded from healthy late preterm babies at the 48th hour of life. PI was determined simultaneously with LVO as measured by transthoracic echocardiography. A total of 50 late preterm babies were included in the study. The mean gestational age of the cases was 35.4 ± 0.7 weeks and the birth weight was 2586 ± 362 g. Mean pre- and post-ductal PI values at the postnatal 48th hour of babies’ life were found to be 2.0 ± 0.9 and 1.7 ± 1.1. The mean LVO value was 438 ± 124, LVO/kg 175 ± 50. When the LVO value was normalized according to the babies’ body weight, there was no statistically significant correlation between the pre- and post-ductal PI and the LVO / kg value (r < 0.2, p > 0.05 in both comparisons). Conclusion: There was no correlation between pre- and post-ductal PI and LVO values in healthy late preterm infants. This may be due to the failure of the LVO, a systemic hemodynamic parameter, to accurately reflect microvascular blood flow due to incomplete maturation of the sympathetic nervous system involved in the regulation of peripheral tissue perfusion in preterm babies.

scholarly journals Correlation between Perfusion Index and Left Ventricular Output in Healthy Late Preterm Infants

2021 ◽  
Author(s):  
Ayça Aytekin ◽  
Nilay Hakan ◽  
Özkan İlhan ◽  
Mustafa Aydin ◽  
Haşim Olgun
Keyword(s):  
Preterm Infants ◽  
Left Ventricular ◽  
Perfusion Index ◽  
Late Preterm ◽  
Microvascular Blood Flow ◽  
Systemic Hemodynamic ◽  
Late Preterm Infants ◽  
Preterm Babies ◽  
Left Ventricular Output ◽  
The Mean

Aim The perfusion index (PI) is a noninvasive marker derived from photoelectric plethysmographic signals in pulse oximetry in the evaluation of peripheral perfusion. This study was aimed to determine the correlation between PI and left ventricular output (LVO) in healthy late preterm infants at 48th hour of life. Methods With new generation pulse oximeter (MASIMO Rad 7 Oximeter) pre- and post-ductal PI values were recorded from healthy late preterm babies at the 48th hour of life. PI was determined simultaneously with LVO as measured by transthoracic echocardiography. Results A total of 50 late preterm babies were included in the study. The mean gestational age of the cases was 35.4 ± 0.7 weeks and the birth weight was 2,586 ± 362 g. Mean pre- and post-ductal PI values at the postnatal 48th hour of babies' life were found to be 2.0 ± 0.9 and 1.7 ± 1.1. The mean LVO value was 438 ± 124, LVO/kg 175 ± 50. When the LVO value was normalized according to the babies' body weight, there was no statistically significant correlation between the pre- and post-ductal PI and the LVO/kg value (r <0.2, p >0.05 in both comparisons). Conclusion There was no correlation between pre- and post-ductal PI and LVO values in healthy late preterm infants. This may be due to the failure of the LVO, a systemic hemodynamic parameter, to accurately reflect microvascular blood flow due to incomplete maturation of the sympathetic nervous system involved in the regulation of peripheral tissue perfusion in preterm babies. Key Points

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