The Relationship between blood pressure parameters and left ventricular output in neonates

J Perinatol. 2019 May;39(5):619-625. doi: 10.1038/s41372-019-0337-6. Epub 2019 Feb 15.


Objective: To evaluate the relationship between systolic (SBP), diastolic (DBP), mean (MBP) blood pressures and pulse pressure (PP), and left ventricular output (LVO), a surrogate of systemic blood flow.

Study design: This retrospective study included neonates who underwent targeted neonatal echocardiography (TNE) in 3-tertiary NICUs over 2 years. Associations between LVO and BP components were investigated. Analysis was adjusted for relevant covariates.

Result: 1060 studies from 485 neonates were included, with a mean GA of 28.4 ± 4.6 weeks and birth weight of 1234 ± 840 grams. LVO was associated positively with SBP and PP, and negatively with GA. PP demonstrated the highest predictive value for identifying infants with LVO < 150 ml/kg/min (area under the curve 0.75 [95% CI 0.68, 0.82]). MBP and DBP demonstrated no correlation with LVO.

Conclusion: BP parameters correlate poorly with LVO, irrespective of GA and underlying etiology. Narrow PP may be more reflective of low LVO than low SBP.

Publication types

  • Multicenter Study

MeSH terms

  • Blood Pressure Determination
  • Blood Pressure*
  • Cardiac Output*
  • Echocardiography, Doppler*
  • Female
  • Humans
  • Infant, Extremely Low Birth Weight
  • Infant, Extremely Premature
  • Infant, Newborn
  • Intensive Care Units, Neonatal
  • Male
  • Ontario
  • ROC Curve
  • Retrospective Studies
  • Ventricular Function, Left*