| Hemodynamic effects of delayed cord clamping in premature infants. | |
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MedLine Citation:
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PMID: 22331336 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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BACKGROUND AND OBJECTIVE: Delayed cord clamping (DCC) has been advocated during preterm delivery to improve hemodynamic stability during the early neonatal period. The hemodynamic effects of DCC in premature infants after birth have not been previously examined. Our objective was to compare the hemodynamic differences between premature infants randomized to either DCC or immediate cord clamping (ICC). METHODS: This prospective study was conducted on a subset of infants who were enrolled in a randomized controlled trial to evaluate the effects of DCC versus ICC. Entry criteria included gestational ages of 24(0) to 31(6) weeks. Twins and infants of mothers with substance abuse were excluded. Serial Doppler studies were performed at 6 ± 2, 24 ± 4, 48 ± 6, and 108 ± 12 hours of life. Measurements included superior vena cava blood flow, right ventricle output, middle cerebral artery blood flow velocity (BFV), superior mesenteric artery BFV, left ventricle shortening fraction, and presence of a persistent ductus arteriosus. RESULTS: Twenty-five infants were enrolled in the DCC group and 26 in the ICC group. Gestational age, birth weight, and male gender were similar. Admission laboratory and clinical events were also similar. DCC resulted in significantly higher superior vena cava blood flow over the study period, as well as greater right ventricle output and right ventricular stroke volumes at 48 hours. No differences were noted in middle cerebral artery BFV, mean superior mesenteric artery BFV, shortening fraction, or the incidence of a persistent ductus arteriosus. CONCLUSIONS: DCC in premature infants is associated with potentially beneficial hemodynamic changes over the first days of life. |
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Authors:
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Ross Sommers; Barbara S Stonestreet; William Oh; Abbot Laptook; Toby Debra Yanowitz; Christina Raker; Judith Mercer |
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Publication Detail:
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Type: Comparative Study; Journal Article; Randomized Controlled Trial; Research Support, N.I.H., Extramural Date: 2012-02-13 |
Journal Detail:
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Title: Pediatrics Volume: 129 ISSN: 1098-4275 ISO Abbreviation: Pediatrics Publication Date: 2012 Mar |
Date Detail:
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Created Date: 2012-03-02 Completed Date: 2012-04-25 Revised Date: 2013-04-15 |
Medline Journal Info:
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Nlm Unique ID: 0376422 Medline TA: Pediatrics Country: United States |
Other Details:
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Languages: eng Pagination: e667-72 Citation Subset: AIM; IM |
Affiliation:
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Department of Neonatology, Women & Infants Hospital of Rhode Island & Alpert Medical School of Brown University, Providence, RI 02905, USA. drsommers@gmail.com |
| Data Bank Information | |
Bank Name/Acc. No.:
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ClinicalTrials.gov/NCT00818220 |
Export Citation:
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APA/MLA Format Download EndNote Download BibTex |
| MeSH Terms | |
Descriptor/Qualifier:
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Analysis of Variance Blood Flow Velocity / physiology Cerebral Hemorrhage / prevention & control Constriction Delivery, Obstetric / methods* Ductus Arteriosus, Patent / prevention & control Female Follow-Up Studies Hemodynamics / physiology* Humans Infant, Newborn Infant, Premature* Infant, Premature, Diseases / prevention & control*, ultrasonography Male Oxygen Consumption / physiology Prospective Studies Risk Assessment Time Factors Treatment Outcome Ultrasonography, Doppler / methods Umbilical Cord* |
| Grant Support | |
ID/Acronym/Agency:
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5R01NR010015/NR/NINR NIH HHS |
| Comments/Corrections | |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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