Bedside detection of low systemic flow in the very low birth weight infant on day 1 of life.
AffiliationDepartment of Paediatrics and Newborn Medicine, Coombe Women and Infants, University Hospital, Dolphin's Barn, Dublin 8, Ireland. email@example.com
MeSH*Blood Flow Velocity
*Infant, Very Low Birth Weight
Intensive Care, Neonatal/methods
Sensitivity and Specificity
Vena Cava, Superior/*physiopathology/ultrasonography
MetadataShow full item record
CitationEur J Pediatr. 2009 Jul;168(7):809-13. Epub 2008 Sep 26.
JournalEuropean journal of pediatrics
AbstractWe aimed to assess the relationship between the clinical and biochemical parameters of perfusion and superior vena cava (SVC) flow in a prospective observational cohort study of very low birth weight (VLBW) infants. Newborns with congenital heart disease were excluded. Echocardiographic evaluation of SVC flow was performed in the first 24 h of life. Capillary refill time (forehead, sternum and toe), mean blood pressure, urine output and serum lactate concentration were also measured simultaneously. Thirty-eight VLBW infants were examined. Eight patients (21%) had SVC flow less than 40 ml/kg/min. There was a poor correlation between the capillary refill time (in all sites), mean blood pressure, urine output and SVC flow. The correlation coefficient for the serum lactate concentration was r = -0.28, p = 0.15. The median serum lactate concentration was 3.5 (range 2.8-8.5) vs. 2.7 (range 1.2-6.9) mmol/l (p = 0.01) in low flow versus normal flow states. A serum lactate concentration of >2.8 was 100% sensitive and 60% specific for detecting a low flow state. Combining a capillary refill time of >4 s with a serum lactate concentration of >4 mmol/l had a specificity of 97% for detecting a low SVC flow state. Serum lactate concentrations are higher in low SVC flow states. A capillary refill time of >4 s combined with serum lactate concentrations >4 mmol/l increased the specificity and positive and negative predictive values of detecting a low SVC flow state.
- Low superior vena cava flow on day 1 and adverse outcome in the very low birthweight infant.
- Authors: Miletin J, Dempsey EM
- Issue date: 2008 Sep
- Serum cortisol values, superior vena cava flow and illness severity scores in very low birth weight infants.
- Authors: Miletin J, Pichova K, Doyle S, Dempsey EM
- Issue date: 2010 Aug
- Cerebral tissue oxygenation index and superior vena cava blood flow in the very low birth weight infant.
- Authors: Moran M, Miletin J, Pichova K, Dempsey EM
- Issue date: 2009 Jan
- The perfusion index derived from a pulse oximeter for predicting low superior vena cava flow in very low birth weight infants.
- Authors: Takahashi S, Kakiuchi S, Nanba Y, Tsukamoto K, Nakamura T, Ito Y
- Issue date: 2010 Apr
- Clinical detection of low upper body blood flow in very premature infants using blood pressure, capillary refill time, and central-peripheral temperature difference.
- Authors: Osborn DA, Evans N, Kluckow M
- Issue date: 2004 Mar