Cardiac output and cerebral blood flow velocity in small for gestational age infants during the first 5 days after birth

Guajardo, Carlos D; Mandelbaum, V. H. A.; Linderkamp, Otwin

doi:10.1016/0378-3782(94)90078-7

Cited by 14 publications

(10 citation statements)

References 22 publications

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“…The younger the animal the greater is the relative size of the heart (Schultz & Giordano, 1962). The aortic diameter and the heart weight related to body weight were very similar to those found in preterm infants, while the calculated physiological measurements -cardiac output and velocities across the four valves corresponded closely to those reported in term humans (Walther et al 1985;Hirsimaki et al 1988;Hudson et al 1990;Gossler & Goldberg, 1991;Agata et al 1994;Guajardo et al 1994). An exception is the anatomical arrangement of the liver veins (Silver et al 1988).…”

Section: Discussionsupporting

confidence: 66%

Cardiac function and morphology studied by two‐dimensional doppler echocardiography in unsedated newborn pigs

Fugelseth

Šatas

Runde

et al. 1999

Experimental Physiology

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S U M M A R YThe newborn pig is currently the most used species in animal neonatal research. Valid noninvasive monitoring is important in particular for long-term survival of unsedated aniimals. In the unsedated newborn pig ( n = 35, median age 24 h, range 7-48 h) we standairdized twodimensional Doppler echocardiography and determined the normal ranges for cardiac function. Probe positioning had to be adjusted to the V-shaped thorax and the mid-line position of the heart. Six out of the sixteen animals c 20 h had a patent ductus arteriosus compared with one of the twenty animals > 20 h old. One atrial septal defect (5 mm) and one small ventricular septal defect were diagnosed. The average heart size was 0.7-0.9 % of body weight which is similar to human infants of the same size. The mean aortic diameter was 6.0 f 0.5 mm (mean f s.D.) and cardiac output was 0.38 Ifr 0.08 1 min-'; both correlate with body weight (r = 0.80 and 0.73, respectively).Tricuspid regurgitation velocity was 3.0 f 0.4 m s-' (mean f S.D.), giving an estimated pressure gradient across the tricuspid valve of 37 f 9.7 mmHg. The aortic diameter and the heart weight per kg body weight are comparable to those reported for preterm neonates. The cardiac output and velocities across the four valves are more comparable with term neonates.

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Section: Discussionsupporting

confidence: 66%

Cardiac function and morphology studied by two‐dimensional doppler echocardiography in unsedated newborn pigs

Fugelseth

Šatas

Runde

et al. 1999

Experimental Physiology

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“…Contrasting results, however, have been reported [45,49,50,51]. Blood flow velocity is not only influenced by flow volume and vessel diameter, but also by other factors such as haematocrit and vessel wall elastic properties [52].…”

Section: Postnatal Cerebral Circulation Following Brain-sparingmentioning

confidence: 78%

Brain-Sparing in Intrauterine Growth Restriction: Considerations for the Neonatologist

2015

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Intrauterine growth restriction (IUGR) is most commonly caused by placental insufficiency, in response to which the fetus adapts its circulation to preserve oxygen and nutrient supply to the brain (‘brain-sparing'). Currently, little is known about the postnatal course and consequences of this antenatal adaptation of the cerebral circulation. The altered cerebral haemodynamics may persist after birth, which would imply a different approach with regard to cerebral monitoring and clinical management of IUGR preterm neonates than their appropriately grown peers. Few studies are available with regard to this topic, and the small body of evidence shows controversy. This review discusses the cerebral circulatory adaptations of IUGR fetuses and appraises the available literature on their postnatal cerebral circulation with potential clinical consequences.

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“…At the age of 3 months, the transient changes in blood volume (38) and metabolism that follow parturition have largely stabilized, and the maturation of biological rhythms of the cardiovascular and thermoregulatory system would have occurred (39,40). Of particular relevance is the observation that hematocrit, a key determinant of blood viscosity and hence red-cell flux is reported to be high in lowbirth-weight neonates during the first few days of life (41), which may have contributed to the profound reduction in skin blood flow in 3-day-old small-forgestational-age infants observed by Martin et al (21).…”

Section: Discussionmentioning

confidence: 99%

Impaired Microvascular Vasodilatory Function in 3-Month-Old Infants of Low Birth Weight

et al. 2001

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OBJECTIVE -Low birth weight has been linked to an increased risk of type 2 diabetes and cardiovascular disease in adult life. The fetal insulin hypothesis proposed that a genetic predisposition to insulin resistance may also influence vascular development. Therefore, impaired vascular function may be an intrinsic abnormality in low-birth weight infants that antedates clinical features of the insulin resistance syndrome.RESEARCH DESIGN AND METHODS -Two groups of 3-month-old term infants were included in the study: 17 infants of lowest quartile birth weight (LQBW) and 21 infants of highest quartile birth weight (HQBW). Three aspects of skin microvascular function were examined; response to local heating, response to acetylcholine iontophoresis, and capillary density.RESULTS -Median (interquartile ranges) birth weights of the LQBW and HQBW infants were 3,140 g (2,738 -3,254) and 3,920 g (3,750 -4,020), respectively. Skin maximal hyperemic response to local heating was 2.14 V (1.68 -2.30) in the LQBW group vs. 2.44 V (1.96 -2.90) in the HQBW group (P ϭ 0.020), and the endothelium-dependent vasodilatory response was 1.03 V (0.62-1.32) in the LQBW group vs. 0.78 V (0.45-1.32) in the HQBW group (P ϭ 0.297). Capillary density in the LQBW and HQBW groups were 46.3 mm Ϫ2 (40.1-53.7) and 44.1 mm Ϫ2 (41.7-56.0), respectively (P ϭ 0.736).CONCLUSIONS -Skin maximal hyperemic response was lower in LQBW infants, although no reduction in capillary density or defect in endothelium-dependent vasodilatation was observed. Such a lower maximal hyperemic response in early life in LQBW subjects who are at risk for type 2 diabetes and cardiovascular disease supports the hypothesis that impaired microvascular function is an early antecedent to diabetes in later life. Diabetes Care 24:1102-1107, 2001R etrospective studies in the U.K. have shown that low birth weight is associated with the development of type 2 diabetes, hypertension, and increased cardiovascular mortality in adult life, which are clinical features of insulin resistance syndrome (1). This association is independent of social class and adult BMI and has been confirmed in studies conducted in other populations (2) and countries (3,4). Barker (5) proposed the fetal programming hypothesis to explain the association, stipulating that undernutrition in utero leads to impaired fetal growth, which may permanently program the structure and function of the pancreas, thus predisposing later development of type 2 diabetes. An alternative or complementary explanation is the fetal insulin hypothesis, which states that the same polygenic factors that increase insulin resistance in utero and in adult life produce two phenotypic expressions: an infant of low birth weight and an adult with an increased risk for diabetes and hypertension (6).In parallel with these observations has been the understanding that endothelial dysfunction is a crucial biological determinant of cardiovascular disease (7). Furthermore, impaired endotheliumdependent vasodilatation has been linked to key components of i...

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Cardiac output and cerebral blood flow velocity in small for gestational age infants during the first 5 days after birth

Cited by 14 publications

References 22 publications

Cardiac function and morphology studied by two‐dimensional doppler echocardiography in unsedated newborn pigs

Cardiac function and morphology studied by two‐dimensional doppler echocardiography in unsedated newborn pigs

Brain-Sparing in Intrauterine Growth Restriction: Considerations for the Neonatologist

Impaired Microvascular Vasodilatory Function in 3-Month-Old Infants of Low Birth Weight

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