Electrical velocimetry for non-invasive monitoring of the closure of the ductus arteriosus in preterm infants
| Autor: | N. González Pacheco, M. Arriaga Redondo, N. Navarro Patiño, M. Sánchez Luna, Ana Rodríguez Sánchez de la Blanca |
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| Rok vydání: | 2017 |
| Předmět: |
Cardiac function curve
Male medicine.medical_specialty Cardiac output Hemodynamics Ibuprofen Infant Premature Diseases Contractility 03 medical and health sciences 0302 clinical medicine 030225 pediatrics Internal medicine Ductus arteriosus medicine Humans Cyclooxygenase Inhibitors 030212 general & internal medicine Prospective Studies Cardiac Output Cardiac Surgical Procedures Ductus Arteriosus Patent End-systolic volume business.industry Infant Newborn Gestational age medicine.anatomical_structure Treatment Outcome Pediatrics Perinatology and Child Health Vascular resistance Cardiology Female business Rheology Infant Premature |
| Zdroj: | European journal of pediatrics. 177(2) |
| ISSN: | 1432-1076 |
| Popis: | Closure of a patent ductus arteriosus (PDA) in preterm infants modifies cardiac output and induces adaptive changes in the hemodynamic situation. The present study aims to analyze those changes, through a non-invasive cardiac output monitor based on blood electrical velocimetry, in preterm babies. A prospective observational study of preterm infants with a gestational age of less than 28 weeks, and a hemodynamic significant PDA, requires intravenous ibuprofen or surgical closure. All patients were monitored with electrical velocimetry before treatment and through the following 72 h. Two groups were defined, ibuprofen and surgical closure. Variations of cardiac output were analyzed from the basal situation and at 1, 8, 24, 48, and 72 h on each group. During a 12-month period, 18 patients were studied. The median gestational age in the ibuprofen group (12/18) was 26+5 weeks (25+5–27+3) with a median birth weight of 875 (670–1010) g. The cardiac output index (CI) value was 0.29 l/kg/min (0.24–0.34). Among the patients with confirmed ductus closure (50%), a significant CI decrease was shown (0.24 vs 0.29 l/kg/min; P 0.03) after 72 h (three ibuprofen doses). A statistically significant decrease in systolic volume (SVI) was found: 1.62 vs 1.88 ml/kg, P 0.03 with a decrease in contractility (ICON), 85 vs 140, P 0.02. The gestational age in the surgical group (6/18) was 25+2 weeks (24–26+3) with a median weight of 745 (660–820) g. All patients in this group showed a decrease in the immediate postoperative CI (1 h after surgery) 0.24 vs 0.30 l/kg/min, P 0.05, and a significant decrease in contractility (ICON 77 vs 147, P 0.03). In addition, a no statistically significant decrease in SVI (1.54 vs 1.83 ml/kg, P 0.06), as well as an increase in systemic vascular resistance (10,615 vs 8797 dyn/cm2, P 0.08), were detected. This deterioration was transient without significant differences in the remaining periods of time evaluated. Conclusion: The surgical closure of the PDA in preterm infants causes a transient deterioration of cardiac function linked to a documented decrease in the left ventricular output. The hemodynamic changes detected after pharmacological PDA closure are similar but those patients present a better clinical tolerance to changes in the cardiac output. |
| Databáze: | OpenAIRE |
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