足月小样儿稳定期新生儿的心输出量测量
Cardiac blood flow measurements in stable full term small for gestational age neonates.
作者信息
Banait Nishant, Suryawanshi Pradeep, Malshe Nandini, Nagpal Rema, Lalwani Sanjay
机构信息
Trainee International Fellow in Neonatology, Royal Victoria Infirmary , Newcastle Upon Tyne, UK .
出版信息
J Clin Diagn Res. 2013 Aug;7(8):1651-4. doi: 10.7860/JCDR/2013/5671.3302. Epub 2013 Aug 1.
BACKGROUND
Cardiac blood flow measurements are useful in the haemodynamic management of neonates. Cardiac blood flows can be estimated with functional echocardiography as follows; flow in Superior Vena Cava (SVC), Right Ventricular Outflow (RVO) and Left Ventricular Outflow (LVO). Studies in preterm infants have shown that abnormal superior vena cava flow is associated with poor neurodevelopmental outcomes. To date, normative data on LVO, RVO and SVC flows has been established for term appropriate for gestational age neonates and preterm neonates, but no data is available on RVO, LVO and SVC flows for term small for gestational age neonates.
OBJECTIVE
To determine Right Ventricular Output (RVO), Left Ventricular Output (LVO) and Superior Vena Cava (SVC) flow after the transitional period in stable full term Small for Gestational Age (SGA) neonates.
DESIGN
Observational study.
SETTING
A tertiary care, perinatal centre in western Maharashtra, India.
PARTICIPANTS
Full term (37 to 41 weeks) small for gestational age (weight below 10th percentile for gestational age) infants who were born during the study period.
METHODS
RVO, LVO and SVC flows were measured by functional echocardiography on day 7 of life in stable full term SGA neonates from January 2011 to August 2011. Infants who required respiratory or cardiovascular support and intensive care unit admissions for any indication and those with a clinical suspicion of an infection within 48 hours after data collection were excluded from the study.
STATISTICAL ANALYSES
Unpaired t-test was used to compare SVC flow between symmetric and asymmetric SGA neonates.
MAIN OUTCOME MEASURE
Measurements of RVO, LVO and SVC in term SGA neonates on day 7 of life.
RESULTS
We performed measurements in 52 term SGA neonates with a median (range) birth weight of 2.190 (1.600-2.410) kg. Fifty two measurements were analyzed on day 7. The mean (SD) RVO, LVO and SVC flows were 255.59 (57.42) , 214.61 (52.04) and 126.28 (31.23) mL/kg/min.
CONCLUSION
This study provides RVO, LVO and SVC flow values in a cohort of stable term SGA neonates after the transitional period.
背景
心脏血流测量对新生儿的血流动力学管理很有用。心脏血流可以通过功能超声心动图进行估计，如下所示：上腔静脉（SVC）、右心室流出道（RVO）和左心室流出道（LVO）的血流。对早产儿的研究表明，上腔静脉血流异常与不良的神经发育结局相关。迄今为止，已建立了适于胎龄足月儿和早产儿的LVO、RVO和SVC血流的正常数据，但关于小于胎龄足月儿的RVO、LVO和SVC血流尚无数据。
目的
确定稳定的足月小于胎龄（SGA）新生儿过渡期后的右心室输出量（RVO）、左心室输出量（LVO）和上腔静脉（SVC）血流。
设计
观察性研究。
地点
印度马哈拉施特拉邦西部的一家三级围产期护理中心。
参与者
研究期间出生的足月（37至41周）小于胎龄（体重低于胎龄第10百分位数）的婴儿。
方法
对2011年1月至2011年8月出生的稳定足月SGA新生儿在出生后第7天通过功能超声心动图测量RVO、LVO和SVC血流。需要呼吸或心血管支持以及因任何原因入住重症监护病房的婴儿，以及在数据收集后48小时内临床怀疑有感染的婴儿被排除在研究之外。
统计分析
采用非配对t检验比较对称和不对称SGA新生儿的SVC血流。
主要观察指标
出生后第7天足月SGA新生儿的RVO、LVO和SVC测量值。
结果
我们对52例足月SGA新生儿进行了测量，中位（范围）出生体重为2.190（1.600 - 2.410）kg。在出生后第7天对52次测量结果进行了分析。RVO、LVO和SVC血流的平均（标准差）值分别为255.59（57.42）、214.61（52.04）和126.28（31.23）mL/kg/min。
结论
本研究提供了过渡期后一组稳定的足月SGA新生儿的RVO、LVO和SVC血流值。
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