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Am J Perinatol 2017; 34(10): 1011-1019
DOI: 10.1055/s-0037-1601439
Original Article
Thieme Medical Publishers, Inc. 333 Seventh Avenue, New York, NY 10001, USA

The Impact of Integrated Evaluation of Hemodynamics on Management of Preterm Infants with Late-Onset Compromised Systemic Circulation

Reem Amer
1   Section of Neonatology, Department of Paediatrics, University of Manitoba, Winnipeg, Manitoba, Canada
,
Reem Kalash
1   Section of Neonatology, Department of Paediatrics, University of Manitoba, Winnipeg, Manitoba, Canada
,
Mary M. Seshia
1   Section of Neonatology, Department of Paediatrics, University of Manitoba, Winnipeg, Manitoba, Canada
,
Yasser N. Elsayed
1   Section of Neonatology, Department of Paediatrics, University of Manitoba, Winnipeg, Manitoba, Canada
› Author Affiliations
Further Information

Publication History

06 November 2016

01 March 2017

Publication Date:
06 April 2017 (online)

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Abstract

Objectives To study the impact of integrated evaluation of hemodynamics (IEH), using targeted neonatal echocardiography (TNE), cerebral regional tissue oxygenation (crRTO), and fractional oxygen extraction (FOE), using near-infrared spectroscopy (NIRS) on the management of infants with late-onset compromised systemic circulation (LCSC), and evaluation of the hemodynamic characteristics.

Study Design Retrospective cohort study comparing infants with LCSC who underwent IEH (April 2014 to May 2016) with an earlier EPOCH who did not undergo IEH (January 2012 to March 2014). The primary outcome was the time to recovery.

Results Total 43 infants were included; 18 infants underwent IEH with a median (IQR) 2 (1–3) assessments per infant. The time to recovery was shorter in IEH group with a median (IQR) 28 hours (15–62) compared with non-IEH group 96 hours (30–160). Autoregulation was compromised in 50%, and systemic vascular resistance (SVR) was low in 67%.

Conclusion IEH was associated with shorter time to recovery in infants with LCSC.

Keywords

neonatal hemodynamics - targeted neonatal echocardiography - near-infrared spectroscopy - integrated evaluation of hemodynamics

Note

The material is original research, has not been previously published, and has not been submitted for publication elsewhere while under consideration.


 

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