Document Detail

Hemodynamics in preterm infants with late-onset sepsis.
MedLine Citation:
PMID:  20236658     Owner:  NLM     Status:  MEDLINE    
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.
Koert de Waal; Nick Evans
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Publication Detail:
Type:  Journal Article     Date:  2010-03-16
Journal Detail:
Title:  The Journal of pediatrics     Volume:  156     ISSN:  1097-6833     ISO Abbreviation:  J. Pediatr.     Publication Date:  2010 Jun 
Date Detail:
Created Date:  2010-05-24     Completed Date:  2010-06-17     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  0375410     Medline TA:  J Pediatr     Country:  United States    
Other Details:
Languages:  eng     Pagination:  918-22, 922.e1     Citation Subset:  AIM; IM    
Copyright Information:
Copyright 2010 Mosby, Inc. All rights reserved.
Emma Children's Hospital AMC, Department of Neonatology, Amsterdam, the Netherlands.
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MeSH Terms
Blood Pressure
Cardiac Output*
Hemodynamics / physiology*
Infant, Newborn
Infant, Premature / physiology*
Regional Blood Flow
Sepsis / physiopathology*
Vena Cava, Superior / physiology*
Ventricular Function, Left / physiology
Ventricular Function, Right / physiology

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