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Noninvasive measurements of hemodynamic transition directly after birth.

Noninvasive measurements of hemodynamic transition directly after birth.

Authors :
van Vonderen JJ
Roest AA
Siew ML
Blom NA
van Lith JM
Walther FJ
Hooper SB
te Pas AB
Source :
Pediatric research [Pediatr Res] 2014 Mar; Vol. 75 (3), pp. 448-52. Date of Electronic Publication: 2013 Dec 17.
Publication Year :
2014

Abstract

Background: Cardiac output depends on stroke volume and heart rate (HR). Only HR is used to monitor hemodynamic transition.<br />Methods: In 24 term newborns born via cesarean section, HR and preductal blood pressure (BP) were measured. Also, using echocardiography, left ventricular dimensions and (Doppler derived) left ventricular output (LVO) were examined at 2, 5, and 10 min after birth.<br />Results: Mean (SD) HR and BP did not change with time (mean HR: 157 (21) bpm at 2 min, 154 (17) bpm at 5 min, and 155 (14) bpm at 10 min; mean BP: 51.2 (15.4) mm Hg at 2 min, 50.5 (11.7) mm Hg at 5 min, and 49.6 (9.5) mm Hg at 10 min). Left ventricular end-diastolic diameter increased from 2 to 5 min (14.3 (1.3) vs. 16.3 (1.7) mm; P < 0.001) and stabilized at 10 min (16.7 (1.4) mm). LVO increased between 2 and 5 min (151 (47) vs. 203 (55) ml/kg/min; P < 0.001) and stabilized at 10 min (201 (45) ml/kg/min). LVO increase was associated with rise in left ventricular stroke volume (r = 0.94; P < 0.001), not with rise in HR (r = 0.37; P value not significant).<br />Conclusion: Left ventricular dimensions and LVO significantly increased the first 5 min after birth and stabilized at 10 min, whereas BP remained stable. LVO and left ventricular dimension increase are presumably due to increasing left ventricular preload resulting from pulmonary blood flow and ductal shunting increase.

Details

Language :
English
ISSN :
1530-0447
Volume :
75
Issue :
3
Database :
MEDLINE
Journal :
Pediatric research
Publication Type :
Academic Journal
Accession number :
24346112
Full Text :
https://doi.org/10.1038/pr.2013.241