Children's Hospital at Westmead, Westmead, NSW, Australia.
University of Sydney, Camperdown, Australia.
Pediatr Res. 2019 Jul;86(1):71-76. doi: 10.1038/s41390-019-0348-1. Epub 2019 Feb 21.
To determine associations of low superior vena cava (SVC) flow (≤55 ml/kg/min) and low right ventricular output (RVO) (≤150 ml/kg/min) in preterm infants.
DESIGN/METHODS: An observational study in infants <30 weeks gestation randomized to receive immediate (<10 s) or delayed cord clamping (DCC) (≥60 s).
The study enrolled 265 infants with a mean (SD) gestation 28 (2) weeks. Eighty-six (33%) infants had low SVC flow and 81 (31%) infants had low RVO. In multivariate analysis, low SVC flow was associated with gestation; low RVO was associated with DCC, gender and 5-minute Apgar; whereas mean RVO was negatively associated with both FiO and mean airway pressure (MAP) at 9 h and 24 h. Low SVC flow was associated with ductus arteriosus (DA) treatment. Infants with low RVO had higher mortality on univariate analysis, but this was not significant after adjusting for gestation.
SVC flow was associated with gestation, whilst RVO was associated with placental transfusion, gender, condition at birth, and early respiratory adaptation. Compared to infants with normal values, more infants with low SVC flow were treated for DA, but infants with low RVO had no significant difference in mortality or morbidity.
确定极低上腔静脉（SVC）流量（≤55ml/kg/min）和极低右心室输出（RVO）（≤150ml/kg/min）与早产儿的关联。
方法/设计：这是一项在妊娠<30 周的婴儿中进行的观察性研究，这些婴儿随机分为立即（<10s）或延迟脐带夹闭（DCC）（≥60s）组。
该研究纳入了 265 名妊娠 28（2）周的婴儿，其中 86 名（33%）婴儿的 SVC 流量低，81 名（31%）婴儿的 RVO 低。多变量分析显示，低 SVC 流量与胎龄相关；低 RVO 与 DCC、性别和 5 分钟 Apgar 相关；而平均 RVO 与 FiO 和 9 小时及 24 小时时的平均气道压力（MAP）呈负相关。低 SVC 流量与动脉导管未闭（DA）治疗相关。单变量分析中低 RVO 组的死亡率较高，但在调整胎龄后无统计学意义。
SVC 流量与胎龄相关，而 RVO 与胎盘输血、性别、出生时状况和早期呼吸适应相关。与正常值婴儿相比，更多的低 SVC 流量婴儿接受了 DA 治疗，但低 RVO 婴儿的死亡率或发病率没有显著差异。
