Document Detail


Hemodynamic effects of delayed cord clamping in premature infants.
MedLine Citation:
PMID:  22331336     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
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.
Authors:
Ross Sommers; Barbara S Stonestreet; William Oh; Abbot Laptook; Toby Debra Yanowitz; Christina Raker; Judith Mercer
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Publication Detail:
Type:  Comparative Study; Journal Article; Randomized Controlled Trial; Research Support, N.I.H., Extramural     Date:  2012-02-13
Journal Detail:
Title:  Pediatrics     Volume:  129     ISSN:  1098-4275     ISO Abbreviation:  Pediatrics     Publication Date:  2012 Mar 
Date Detail:
Created Date:  2012-03-02     Completed Date:  2012-04-25     Revised Date:  2014-10-29    
Medline Journal Info:
Nlm Unique ID:  0376422     Medline TA:  Pediatrics     Country:  United States    
Other Details:
Languages:  eng     Pagination:  e667-72     Citation Subset:  AIM; IM    
Data Bank Information
Bank Name/Acc. No.:
ClinicalTrials.gov/NCT00818220
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MeSH Terms
Descriptor/Qualifier:
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:
5R01NR010015/NR/NINR NIH HHS
Comments/Corrections
Comment In:
Enferm Clin. 2014 Sep-Oct;24(5):305-7   [PMID:  24388777 ]

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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