Skip to main content
NCBI home page
Archives of Disease in Childhood logoLink to Archives of Disease in Childhood
. 1993 Jan;68(1 Spec No):17–21. doi: 10.1136/adc.68.1_spec_no.17

Echocardiographic assessment of cardiac function in shocked very low birthweight infants.

A B Gill 1, A M Weindling 1
PMCID: PMC1029159  PMID: 8439190

Abstract

The contribution of abnormal cardiac function to hypotension and metabolic acidosis, which affect approximately 40% of ventilated very low birthweight infants in the first 24 hours after birth was assessed using M mode, two dimensional, and Doppler echocardiography in 75 very low birthweight infants during the first few hours after birth. Thirty four infants whose blood pressure was less than the 10th centile or who had a metabolic acidosis in the first 24 hours were compared with 41 who showed neither feature. The median shortening fraction was significantly lower in the hypotensive/acidotic (shocked) group than in the controls. In 16 of 34 (47%) shocked infants left ventricular contractility and output were significantly worse than in the control subjects. One and five minute Apgar scores were also significantly lower in the shock group when compared with controls. Cardiac dysfunction was an important feature in the shocked very low birthweight infants. It is speculated that volume expansion may not always be the most appropriate first line treatment for such infants.

Full text

PDF
17

Selected References

These references are in PubMed. This may not be the complete list of references from this article.

  1. Alverson D. C., Eldridge M. W., Johnson J. D., Aldrich M., Angelus P., Berman W., Jr Noninvasive measurement of cardiac output in healthy preterm and term newborn infants. Am J Perinatol. 1984 Jan;1(2):148–151. doi: 10.1055/s-2007-999991. [DOI] [PubMed] [Google Scholar]
  2. Alverson D. C., Eldridge M., Dillon T., Yabek S. M., Berman W., Jr Noninvasive pulsed Doppler determination of cardiac output in neonates and children. J Pediatr. 1982 Jul;101(1):46–50. doi: 10.1016/s0022-3476(82)80178-9. [DOI] [PubMed] [Google Scholar]
  3. Bada H. S., Korones S. B., Perry E. H., Arheart K. L., Ray J. D., Pourcyrous M., Magill H. L., Runyan W., 3rd, Somes G. W., Clark F. C. Mean arterial blood pressure changes in premature infants and those at risk for intraventricular hemorrhage. J Pediatr. 1990 Oct;117(4):607–614. doi: 10.1016/s0022-3476(05)80700-0. [DOI] [PubMed] [Google Scholar]
  4. Barr P. A., Bailey P. E., Sumners J., Cassady G. Relation between arterial blood pressure and blood volume and effect of infused albumin in sick preterm infants. Pediatrics. 1977 Sep;60(3):282–289. [PubMed] [Google Scholar]
  5. Bouchard A., Blumlein S., Schiller N. B., Schlitt S., Byrd B. F., 3rd, Ports T., Chatterjee K. Measurement of left ventricular stroke volume using continuous wave Doppler echocardiography of the ascending aorta and M-mode echocardiography of the aortic valve. J Am Coll Cardiol. 1987 Jan;9(1):75–83. doi: 10.1016/s0735-1097(87)80085-2. [DOI] [PubMed] [Google Scholar]
  6. Cabal L. A., Devaskar U., Siassi B., Hodgman J. E., Emmanouilides G. Cardiogenic shock associated with perinatal asphyxia in preterm infants. J Pediatr. 1980 Apr;96(4):705–710. doi: 10.1016/s0022-3476(80)80750-5. [DOI] [PubMed] [Google Scholar]
  7. Cooke R. W. Factors associated with periventricular haemorrhage in very low birthweight infants. Arch Dis Child. 1981 Jun;56(6):425–431. doi: 10.1136/adc.56.6.425. [DOI] [PMC free article] [PubMed] [Google Scholar]
  8. Evans N. J., Archer L. N. Doppler assessment of pulmonary artery pressure and extrapulmonary shunting in the acute phase of hyaline membrane disease. Arch Dis Child. 1991 Jan;66(1 Spec No):6–11. doi: 10.1136/adc.66.1_spec_no.6. [DOI] [PMC free article] [PubMed] [Google Scholar]
  9. Feigenbaum H., Popp R. L., Wolfe S. B., Troy B. L., Pombo J. F., Haine C. L., Dodge H. T. Ultrasound measurements of the left ventricle. A correlative study with angiocardiography. Arch Intern Med. 1972 Mar;129(3):461–467. [PubMed] [Google Scholar]
  10. Finley J. P., Howman-Giles R. B., Gilday D. L., Bloom K. R., Rowe R. D. Transient myocardial ischemia of the newborn infant demonstrated by thallium myocardial imaging. J Pediatr. 1979 Feb;94(2):263–270. doi: 10.1016/s0022-3476(79)80841-0. [DOI] [PubMed] [Google Scholar]
  11. Halliday H., Hirschfeld S., Riggs T., Liebman J., Fanaroff A. Echographic ventricular systolic time intervals in normal term and preterm neonates. Pediatrics. 1978 Sep;62(3):317–321. [PubMed] [Google Scholar]
  12. Hirschfeld S., Meyer R., Schwartz D. C., Korfhagen J., Kaplan S. Measurement of right and left ventricular systolic time intervals by echocardiography. Circulation. 1975 Feb;51(2):304–309. doi: 10.1161/01.cir.51.2.304. [DOI] [PubMed] [Google Scholar]
  13. Mathey D. G., Decoodt P. R., Allen H. N., Swan H. J. Abnormal left ventricular contraction pattern in the systolic click-late systolic murmur syndrome. Circulation. 1977 Aug;56(2):311–315. doi: 10.1161/01.cir.56.2.311. [DOI] [PubMed] [Google Scholar]
  14. Miall-Allen V. M., de Vries L. S., Whitelaw A. G. Mean arterial blood pressure and neonatal cerebral lesions. Arch Dis Child. 1987 Oct;62(10):1068–1069. doi: 10.1136/adc.62.10.1068. [DOI] [PMC free article] [PubMed] [Google Scholar]
  15. Quinones M. A., Pickering E., Alexander J. K. Percentage of shortening of the echocardiographic left ventricular dimension. Its use in determining ejection fraction and stroke volume. Chest. 1978 Jul;74(1):59–65. doi: 10.1378/chest.74.1.59. [DOI] [PubMed] [Google Scholar]
  16. Rowe R. D., Hoffman T. Transient myocardial ischemia of the newborn infant: a form of severe cardiorespiratory distress in full-term infants. J Pediatr. 1972 Aug;81(2):243–250. doi: 10.1016/s0022-3476(72)80290-7. [DOI] [PubMed] [Google Scholar]
  17. Sahn D. J., DeMaria A., Kisslo J., Weyman A. Recommendations regarding quantitation in M-mode echocardiography: results of a survey of echocardiographic measurements. Circulation. 1978 Dec;58(6):1072–1083. doi: 10.1161/01.cir.58.6.1072. [DOI] [PubMed] [Google Scholar]
  18. Skinner J. R., Boys R. J., Hunter S., Hey E. N. Non-invasive assessment of pulmonary arterial pressure in healthy neonates. Arch Dis Child. 1991 Apr;66(4 Spec No):386–390. doi: 10.1136/adc.66.4_spec_no.386. [DOI] [PMC free article] [PubMed] [Google Scholar]
  19. Smith J. E., John E. Neonatal hypotension: two years' experience in a neonatal intensive care nursery. Aust Paediatr J. 1983 Sep;19(3):162–164. [PubMed] [Google Scholar]
  20. Szymonowicz W., Yu V. Y., Wilson F. E. Antecedents of periventricular haemorrhage in infants weighing 1250 g or less at birth. Arch Dis Child. 1984 Jan;59(1):13–17. doi: 10.1136/adc.59.1.13. [DOI] [PMC free article] [PubMed] [Google Scholar]
  21. Walther F. J., Siassi B., King J., Wu P. Y. Echocardiographic measurements in normal preterm and term neonates. Acta Paediatr Scand. 1986 Jul;75(4):563–568. doi: 10.1111/j.1651-2227.1986.tb10251.x. [DOI] [PubMed] [Google Scholar]
  22. Walther F. J., Siassi B., Ramadan N. A., Ananda A. K., Wu P. Y. Pulsed Doppler determinations of cardiac output in neonates: normal standards for clinical use. Pediatrics. 1985 Nov;76(5):829–833. [PubMed] [Google Scholar]
  23. Watkins A. M., West C. R., Cooke R. W. Blood pressure and cerebral haemorrhage and ischaemia in very low birthweight infants. Early Hum Dev. 1989 May;19(2):103–110. doi: 10.1016/0378-3782(89)90120-5. [DOI] [PubMed] [Google Scholar]

Articles from Archives of Disease in Childhood are provided here courtesy of BMJ Publishing Group

RESOURCES