OPEN IN READ APP
JOURNAL ARTICLE

Measurement of systemic oxygen delivery and inotropy in healthy term neonates with the Ultrasonic Cardiac Output Monitor (USCOM)

Shao-Ru He, Xin Sun, Cheng Zhang, Zhuang Jian, Yun-Xia Sun, Man-Li Zheng, Yu-Mei Liu, Veronica M Madigan, Brendan E Smith
Early Human Development 2013, 89 (5): 289-94
23164929

INTRODUCTION: The aim of this study was to assess the normal values for Smith-Madigan inotropy (SMI), Smith-Madigan inotropy index (SMII), oxygen delivery (DO2) and oxygen delivery index DO2I in healthy term neonates on the first day of life and during circulatory adaptation over the first three days of life.

METHODS: Hemodynamics of the left heart were measured non-invasively in 71 normal full-term neonates over the first three days using the Ultrasonic Cardiac Output Monitor (USCOM). This was combined with hemoglobin concentration from umbilical cord blood and pulse oximetry to calculate DO2 and DO2I. Blood pressure was measured using automated oscillometry and combined with the hemodynamic measures and hemoglobin concentration using the Smith-Madigan method to calculate inotropy (SMI) and inotropy index (SMII).

RESULTS: SMI and SMII showed no significant change during the study period, ranging from 154 to 168 mW and 694 to 731 mW/m(2). Mean (SD) DO2 and DO2I showed a significant fall over three days from 131 (63) ml/min and 596 (278) ml/m(2)/min to 118 (46) ml/min and 517 (173) ml/m(2)/min (p<0.01 and <0.001 respectively) with a corresponding decrease in cardiac output from 758 (143) ml/min to 658 (131) ml/min, (p=0.002). There was no significant change in stroke volume, heart rate, SMI or SMII within the first day. DO2 and DO2I showed small but significant decreases within the first day from 153 (46) ml/min and 699 (174) ml/min/m(2) to 129 (36) ml/min and 609 (141) ml/min/m(2) (p=0.017 and 0.048 respectively).

CONCLUSIONS: Normal inotropy of the left heart and systemic DO2 values in healthy full-term neonates over the first three days of life were assessed using the USCOM. Subjects showed stable myocardial contractility over the first three days with decreasing DO2 and DO2I in line with the decrease in cardiac output (CO). DO2 and DO2I showed small but significant reductions during the first 24 h. USCOM proved to be a feasible and convenient non-invasive bedside tool to assess inotropy and oxygen delivery in neonates.

Discussion

You are not logged in. Sign Up or Log In to join the discussion.

Related Papers

Available on the App Store

Available on the Play Store
Remove bar
Read by QxMD icon Read
23164929
×

Search Tips

Use Boolean operators: AND/OR

diabetic AND foot
diabetes OR diabetic

Exclude a word using the 'minus' sign

Virchow -triad

Use Parentheses

water AND (cup OR glass)

Add an asterisk (*) at end of a word to include word stems

Neuro* will search for Neurology, Neuroscientist, Neurological, and so on

Use quotes to search for an exact phrase

"primary prevention of cancer"
(heart or cardiac or cardio*) AND arrest -"American Heart Association"