Sabatino G, Ramenghi L A, Verrotti A, Gerboni S, Chiarelli F
Neonatal Intensive Care Unit, University of Chieti, Italy.
Panminerva Med. 1998 Mar;40(1):28-32.
Cardiogenic shock is an acute "unstable" state of circulatory dysfunction.
To evaluate the haemodynamic aspects of 45 newborn infants affected by cardiogenic shock, in relation to etiologies and the mortality rate.
Retrospective, correlation study of etiologies, mortality rate and haemodynamic measurements by Doppler ultrasound parameters.
45 newborn infants with cardiogenic shock, Gestational Age (GA) 37 (34-41), Birth Weight (BW) 2750 (1600-3600) g and and a control group of 20 neonates [GA 38 (34-40) wks, BW 2960 (1750-3800) g].
Left ventricular Cardiac Output (CO) was measured by a duplex scanner with pulsed Doppler and color flow mapping echocardiography in the first 48 hours of life.
In healthy newborns CO was 240 mL/min/kg (210-280), in newborns with cardiogenic shock CO was 170 mL/min/kg (f130-200), p < 0.01. The Stroke Volume was 1.80 mL/kg (1.70-1.90) in the control group and 1.20 (1.15-1.80) in the shocked group (p < 0.05); Heart Rate was 146 beats/min (130-160) and 160 beats/mm (140-194), (p < 0.01) respectively. Twenty-nine infants with cardiogenic shock had CO < or = 150 mL/min/kg and 5 of them (17.2%) died; 16 neonates had CO > 150 mL/min/kg and only one (6.2%) died (p < .01). Twenty-six of 36 newborns with perinatal asphyxia had CO < or = mL/min/kg and 5 of them died, while only one of 10 infants with CO > 150 mL/min/kg died.
Our results show that persistently low CO (< or = mL/min/kg) during the first 48 hours life, in newborns with cardiogenic shock due to perinatal asphyxia is associated with a significantly higher mortality.
心源性休克是循环功能障碍的一种急性“不稳定”状态。
评估45例受心源性休克影响的新生儿的血流动力学情况，及其与病因和死亡率的关系。
对病因、死亡率以及通过多普勒超声参数进行的血流动力学测量进行回顾性相关性研究。
45例心源性休克新生儿，胎龄（GA）37（34 - 41）周，出生体重（BW）2750（1600 - 3600）克，以及一个由20例新生儿组成的对照组[胎龄38（34 - 40）周，出生体重2960（1750 - 3800）克]。
在出生后的头48小时内，使用带有脉冲多普勒和彩色血流图超声心动图的双功能扫描仪测量左心室心输出量（CO）。
健康新生儿的心输出量为240毫升/分钟/千克（210 - 280），心源性休克新生儿的心输出量为170毫升/分钟/千克（130 - 200），p < 0.01。对照组的每搏输出量为1.80毫升/千克（1.70 - 1.90），休克组为1.20（1.15 - 1.80）（p < 0.05）；心率分别为146次/分钟（130 - 160）和160次/分钟（140 - 194），（p < 0.01）。29例心源性休克婴儿的心输出量≤150毫升/分钟/千克，其中5例（17.2%）死亡；16例新生儿的心输出量>150毫升/分钟/千克，仅1例（6.2%）死亡（p < 0.01）。36例围产期窒息新生儿中有26例的心输出量≤150毫升/分钟/千克，其中5例死亡，而心输出量>150毫升/分钟/千克的10例婴儿中仅1例死亡。
我们的结果表明，在出生后48小时内，因围产期窒息导致心源性休克的新生儿持续低心输出量（≤150毫升/分钟/千克）与显著更高的死亡率相关。
