- Title
- Hemodynamics in preterm infants with late-onset sepsis
- Creator
- de Waal, Koert; Evans, Nick
- Relation
- Journal of Pediatrics Vol. 156, Issue 6, p. 918-922, 922.e1
- Publisher Link
- http://dx.doi.org/10.1016/j.jpeds.2009.12.026
- Publisher
- Mosby
- Resource Type
- journal article
- Date
- 2010
- Description
- Objective: To describe the hemodynamic changes with time in preterm infants with clinical sepsis. Study design: Blood pressure, right ventricular output (RVO), left ventricular output (LVO), and superior vena cava (SVC) flow of infants who had a suspected infection and showed signs of cardiovascular compromise were measured every 12 hours or until there was considered clinical improvement. Results: Twenty infants with a median gestational age of 27 weeks (range, 25-32 weeks) and weight of 995 g (range, 650-1980 g) were examined. Five patients died. The mean (SD) RVO, LVO, and SVC flow at the first measurement were 555 (133), 441 (164), and 104 (39) mL/kg/min, respectively. The calculated systemic vascular resistance (SVR) was 0.08 (0.04) mm Hg/mL/kg/min. There was no significant change in flow in the 15 surviving infants. Blood pressure and SVR increased from the first to the last measurement (mean difference: blood pressure, 8 mm Hg; 95% CI 3 to −13; systemic vascular resistance, 0.02 mm Hg/mL/kg/min; 95% CI, 0.01 to −0.04). Flows decreased and SVR increased in the 5 non-surviving infants (mean difference: RVO, −318 mL/kg/min; 95% CI, −463 to −174; LVO, −292 mL/kg/min; 95% CI, −473 to −111; SVC flow, –46 mL/kg/min; 95% CI, −77 to −16). Conclusion: Preterm neonates with sepsis have relatively high left and right cardiac outputs and low SVRs. A decrease in RVO or LVO >50% compared with the initial measurement is associated with mortality.
- Subject
- hemodynamic changes; preterm infants; clinical sepsis; cardiovascular compromise
- Identifier
- http://hdl.handle.net/1959.13/930211
- Identifier
- uon:10796
- Identifier
- ISSN:0022-3476
- Language
- eng
- Reviewed
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