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Superior vena cava flow in newborn infants: a novel marker of systemic blood flow

Archives of disease in childhood. Fetal and neonatal edition, 2000-05, Vol.82 (3), p.F182-F187 [Peer Reviewed Journal]

Royal College of Paediatrics and Child Health ;2000 INIST-CNRS ;Copyright: 2000 Royal College of Paediatrics and Child Health ;ISSN: 1359-2998 ;EISSN: 1468-2052 ;DOI: 10.1136/fn.82.3.F182 ;PMID: 10794783

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Title:
Superior vena cava flow in newborn infants: a novel marker of systemic blood flow
Author: Kluckow, Martin ; Evans, Nick
Subjects: Anesthesia. Intensive care medicine. Transfusions. Cell therapy and gene therapy ; Babies ; Biological and medical sciences ; Birth weight ; Blood ; Blood Flow Velocity ; Ductus Arteriosus - diagnostic imaging ; Ductus Arteriosus - physiology ; Echocardiography, Doppler ; Emergency and intensive care: neonates and children. Prematurity. Sudden death ; Flow velocity ; Heart ; Humans ; Infant, Newborn - physiology ; Infant, Premature - physiology ; Intensive care medicine ; Medical sciences ; Newborn babies ; Original ; Premature birth ; preterm infants ; Reference Values ; Regional Blood Flow - physiology ; reproducibility ; Reproducibility of Results ; superior vena cava ; systemic blood flow ; Ultrasonic imaging ; Vena Cava, Superior - diagnostic imaging ; Vena Cava, Superior - physiology ; Ventricular Function, Right - physiology
Is Part Of: Archives of disease in childhood. Fetal and neonatal edition, 2000-05, Vol.82 (3), p.F182-F187
Description: BACKGROUND Ventricular outputs cannot be used to assess systemic blood flow in preterm infants because they are confounded by shunts through the ductus arteriosus and atrial septum. However, flow measurements in the superior vena cava (SVC) can assess blood returning from the upper body and brain. OBJECTIVES To describe a Doppler echocardiographic technique that measures blood flow in the SVC, to test its reproducibility, and to establish normal ranges. DESIGN SVC flow was assessed together with right ventricular output and atrial or ductal shunting. Normal range was established in 14 infants born after 36 weeks' gestation (2 measurements taken in the first 48 hours) and 25 uncomplicated infants born before 30 weeks (4 measurements taken in the first 48 hours). Intra-observer and interobserver variability were tested in 20 preterm infants. RESULTS In 14 infants born after 36 weeks, median SVC flow rose from 76 ml/kg/min on day 1 to 93 ml/kg/min on day 2; in 25 uncomplicated very preterm infants, it rose from 62 ml/kg/min at 5 hours to 86 ml/kg/min at 48 hours. The lowest SVC flow for the preterm babies rose from 30 ml/kg/min at 5 hours to 46 ml/kg/min by 48 hours. Median intra-observer and interobserver variability were 8.1% and 14%, respectively. In preterm babies with a closed duct, SVC flow was a mean of 37% of left ventricular output and the two measures correlated significantly. CONCLUSIONS This technique can assess blood flow from the upper body, including the brain, in the crucial early postnatal period, and might allow more accurate assessment of the status of systemic blood flow and response to treatment. Key messages Superior vena cava flow offers a non-invasive means to assess systemic blood flow in newborn infants Superior vena cava flow increases over the first 48 hours in well term and preterm infants
Publisher: London: BMJ Publishing Group Ltd and Royal College of Paediatrics and Child Health
Language: English
Identifier: ISSN: 1359-2998
EISSN: 1468-2052
DOI: 10.1136/fn.82.3.F182
PMID: 10794783
Source: PubMed
MEDLINE
Alma/SFX Local Collection
ProQuest Central

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Superior vena cava flow in newborn infants: a novel marker of systemic blood flow

Royal College of Paediatrics and Child Health ;2000 INIST-CNRS ;Copyright: 2000 Royal College of Paediatrics and Child Health ;ISSN: 1359-2998 ;EISSN: 1468-2052 ;DOI: 10.1136/fn.82.3.F182 ;PMID: 10794783

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