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dc.contributor.authorMoran, M
dc.contributor.authorMiletin, J
dc.contributor.authorPichova, K
dc.contributor.authorDempsey, E M
dc.date.accessioned2012-02-01T10:57:28Z
dc.date.available2012-02-01T10:57:28Z
dc.date.issued2012-02-01T10:57:28Z
dc.identifier.citationActa Paediatr. 2009 Jan;98(1):43-6. Epub 2008 Oct 6.en_GB
dc.identifier.issn1651-2227 (Electronic)en_GB
dc.identifier.issn0803-5253 (Linking)en_GB
dc.identifier.pmid18945276en_GB
dc.identifier.doi10.1111/j.1651-2227.2008.01006.xen_GB
dc.identifier.urihttp://hdl.handle.net/10147/208006
dc.description.abstractBACKGROUND: Superior vena cava (SVC) flow assesses blood flow from the upper body, including the brain. Near infrared spectroscopy (NIRS) provides information on brain perfusion and oxygenation. AIM: To assess the relationship between cerebral tissue oxygenation index (cTOI) and cardiac output measures in the very low birth weight (VLBW) infant in the first day of life. METHODS: A prospective observational cohort study. Neonates with birth weight less than 1500 g (VLBW) were eligible for enrollment. Newborns with congenital heart disease, major congenital malformations and greater than Papile grade1 Intraventricular Haemorrhage on day 1 of life were excluded. Echocardiographic evaluation of SVC flow was performed in the first 24 h of life. Low SVC flow states were defined as a flow less than 40 mL/kg/min. cTOI was measured using NIRO 200 Hamamatsu. RESULTS: Twenty-seven VLBW neonates had both echocardiography and NIRS performed. The median (range) gestation was 29/40 (25 + 3 to 31 + 5 weeks) and median birth weight was 1.2 kg (0.57-1.48 kg). The mean (SD) TOI was 68.1 (7.9)%. The mean (SD) SVC flow was 70.36(39.5) mLs/kg/min. The correlation coefficient of cerebral tissue oxygenation and SVC flow was r = 0.53, p-value 0.005. There was a poor correlation between right and left ventricular output and cTOI which is not surprising considering the influence of intra- and extracardiac shunts. CONCLUSION: There is a positive relationship between cerebral TOI values and SVC flow in the very low birth infant on day one of life.
dc.language.isoengen_GB
dc.subject.meshBrain/*blood supplyen_GB
dc.subject.meshCerebral Ventricles/blood supplyen_GB
dc.subject.mesh*Cerebrovascular Circulationen_GB
dc.subject.meshFemaleen_GB
dc.subject.meshHemodynamicsen_GB
dc.subject.meshHumansen_GB
dc.subject.meshInfant, Newbornen_GB
dc.subject.mesh*Infant, Very Low Birth Weighten_GB
dc.subject.meshMaleen_GB
dc.subject.meshOxygen/*blooden_GB
dc.subject.meshProspective Studiesen_GB
dc.subject.meshRegional Blood Flowen_GB
dc.subject.meshRisk Factorsen_GB
dc.subject.meshSpectroscopy, Near-Infrareden_GB
dc.subject.mesh*Vena Cava, Superioren_GB
dc.titleCerebral tissue oxygenation index and superior vena cava blood flow in the very low birth weight infant.en_GB
dc.contributor.departmentDepartment of Pediatrics and Newborn Medicine, Coombe Women and Infants, University Hospital, Dublin 8, Ireland.en_GB
dc.identifier.journalActa paediatrica (Oslo, Norway : 1992)en_GB
dc.description.provinceLeinster
html.description.abstractBACKGROUND: Superior vena cava (SVC) flow assesses blood flow from the upper body, including the brain. Near infrared spectroscopy (NIRS) provides information on brain perfusion and oxygenation. AIM: To assess the relationship between cerebral tissue oxygenation index (cTOI) and cardiac output measures in the very low birth weight (VLBW) infant in the first day of life. METHODS: A prospective observational cohort study. Neonates with birth weight less than 1500 g (VLBW) were eligible for enrollment. Newborns with congenital heart disease, major congenital malformations and greater than Papile grade1 Intraventricular Haemorrhage on day 1 of life were excluded. Echocardiographic evaluation of SVC flow was performed in the first 24 h of life. Low SVC flow states were defined as a flow less than 40 mL/kg/min. cTOI was measured using NIRO 200 Hamamatsu. RESULTS: Twenty-seven VLBW neonates had both echocardiography and NIRS performed. The median (range) gestation was 29/40 (25 + 3 to 31 + 5 weeks) and median birth weight was 1.2 kg (0.57-1.48 kg). The mean (SD) TOI was 68.1 (7.9)%. The mean (SD) SVC flow was 70.36(39.5) mLs/kg/min. The correlation coefficient of cerebral tissue oxygenation and SVC flow was r = 0.53, p-value 0.005. There was a poor correlation between right and left ventricular output and cTOI which is not surprising considering the influence of intra- and extracardiac shunts. CONCLUSION: There is a positive relationship between cerebral TOI values and SVC flow in the very low birth infant on day one of life.


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