Document Detail


Relationship between blood pressure and cardiac output in preterm infants requiring mechanical ventilation.
MedLine Citation:
PMID:  8859256     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
OBJECTIVE: To assess the contribution of cardiac output in determining the blood pressure of preterm infants and to identify other factors that may be important. METHODS: Sixty-seven preterm infants requiring mechanical ventilation (median birth weight, 1015 gm: median gestational age, 28 weeks) underwent on echocardiographic study at on average age of 19 hours (range, 7 to 31 hours). Measurements taken included left ventricular ejection fraction, left and right ventricular outputs by means of pulsed Doppler and the diameter of both the ductal and atrial shunt jets with the use of color Doppler as a measure of the size of shunt. Simultaneous measurements of intraarterial blood pressures, mean airway pressure, and inspired fraction of oxygen were recorded. RESULTS: After we allowed for the influence of ductal shunting, the correlation between the left ventricular output and mean arterial blood pressure was significant but weak (r = 0.38). There were infants with low blood pressures and normal cardiac outputs, and conversely there were infants with low cardiac outputs and normal blood pressure. The infants with a mean arterial blood pressure of less than 30 mm Hg had a significantly lower gestational age (27 vs 28 weeks), higher mean airway pressure (9.0 vs 7.0 cm H2O), larger ductal diameter (1.6 mm vs 0.7 mm) and a lower systemic vascular resistance (163 vs 184 mm Hg/L per minute per kilogram of body weight). Multilinear regression identified higher mean airway pressure and larger ductal diameter as significant negative influences on mean arterial blood pressure, with higher gestational age and higher left ventricular output as significant positive influences. CONCLUSIONS: Normal blood pressure cannot necessarily be equated with normal systemic now. These data emphasize the importance of other influences, and in particular that of varying systemic vascular resistance, in the determination of blood pressure in preterm infants.
Authors:
M Kluckow; N Evans
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  The Journal of pediatrics     Volume:  129     ISSN:  0022-3476     ISO Abbreviation:  J. Pediatr.     Publication Date:  1996 Oct 
Date Detail:
Created Date:  1996-11-12     Completed Date:  1996-11-12     Revised Date:  2004-11-17    
Medline Journal Info:
Nlm Unique ID:  0375410     Medline TA:  J Pediatr     Country:  UNITED STATES    
Other Details:
Languages:  eng     Pagination:  506-12     Citation Subset:  AIM; IM    
Affiliation:
Department of Perinatal Medicine, King George V Hospital, Part of Royal Prince Alfred Hospitals, Sydney, New South Wales, Australia.
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MeSH Terms
Descriptor/Qualifier:
Blood Pressure*
Cardiac Output*
Ductus Arteriosus / ultrasonography
Echocardiography, Doppler
Heart Septum / ultrasonography
Humans
Infant, Newborn
Infant, Premature, Diseases / physiopathology*,  therapy,  ultrasonography
Lung Diseases / physiopathology*,  therapy,  ultrasonography
Regression Analysis
Respiration, Artificial*
Ultrasonography, Doppler, Color
Ventricular Function, Left
Ventricular Function, Right

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


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