Associations of measures of systemic blood flow used in a randomized trial of delayed cord clamping in preterm infants

Pediatr Res. 2019 Jul;86(1):71-76. doi: 10.1038/s41390-019-0348-1. Epub 2019 Feb 21.

Abstract

Objective: To determine associations of low superior vena cava (SVC) flow (≤55 ml/kg/min) and low right ventricular output (RVO) (≤150 ml/kg/min) in preterm infants.

Design/methods: An observational study in infants <30 weeks gestation randomized to receive immediate (<10 s) or delayed cord clamping (DCC) (≥60 s).

Results: The study enrolled 265 infants with a mean (SD) gestation 28 (2) weeks. Eighty-six (33%) infants had low SVC flow and 81 (31%) infants had low RVO. In multivariate analysis, low SVC flow was associated with gestation; low RVO was associated with DCC, gender and 5-minute Apgar; whereas mean RVO was negatively associated with both FiO2 and mean airway pressure (MAP) at 9 h and 24 h. Low SVC flow was associated with ductus arteriosus (DA) treatment. Infants with low RVO had higher mortality on univariate analysis, but this was not significant after adjusting for gestation.

Conclusions: SVC flow was associated with gestation, whilst RVO was associated with placental transfusion, gender, condition at birth, and early respiratory adaptation. Compared to infants with normal values, more infants with low SVC flow were treated for DA, but infants with low RVO had no significant difference in mortality or morbidity.

Publication types

  • Multicenter Study
  • Observational Study
  • Randomized Controlled Trial
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Australia
  • Blood Flow Velocity*
  • Blood Transfusion
  • Constriction
  • Ductus Arteriosus / physiology
  • Female
  • Gestational Age
  • Heart Ventricles
  • Hemodynamics*
  • Humans
  • Infant, Newborn
  • Infant, Premature / physiology
  • Intensive Care, Neonatal
  • Male
  • Multivariate Analysis
  • Placenta / physiology
  • Pregnancy
  • Pressure
  • Prospective Studies
  • Surgical Instruments*
  • Umbilical Cord / physiology*
  • Vena Cava, Superior / physiology*