Non-invasive measurements of ductus arteriosus flow directly after birth

Vonderen, Jeroen J van; Pas, Arjan B. te; Kolster-Bijdevaate, Clara; Lith, Jan M. van; Blom, Nico A.; Hooper, Stuart B.; Roest, Arno A.W.

doi:10.1136/archdischild-2014-306033

Cited by 41 publications

(53 citation statements)

References 26 publications

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“…In term neonates, three studies reported an increase in LVO and left ventricular stroke volume (LVSV) within the first 10 min [11,12,20]. Winberg et al [25] reported higher LVO and LVSV at 15 min after birth in 16 term neonates delivered by caesarean section compared to vaginally born neonates.…”

Section: Discussionmentioning

confidence: 99%

“…Three studies reported different findings concerning the course of HR: Toth et al [15 ]and Noori et al [20 ]described a decreasing tendency of HR in vaginally delivered newborn infants without any medical support, and van Vonderen et al [11,12] reported in two separate studies no significant change of HR (measured by applying electrodes) in the first 10 min in term newborn infants. This has led to the development of reference ranges describing HR in healthy term and late-preterm (>32 weeks' gestation) neonates without the need of any medical support in the first 10 min [19].…”

Section: Discussionmentioning

confidence: 99%

“…Thirteen studies placed importance on continuous measurement of HR (table 2). Three of them used only electrodes [10,11,12], two used electrodes and pulse oximetry [13,14], seven only pulse oximetry [15,16,17,18,19,20,21] and one did not mention the method of achieving HR [22]. Five studies described blood pressure (BP) during the defined transition period (table 3): one of them measured BP by the Doppler ultrasound method [23]; the other four used the oscillometric technique to achieve the results [11,24,25,26].…”

Section: Resultsmentioning

confidence: 99%

“…Five studies described blood pressure (BP) during the defined transition period (table 3): one of them measured BP by the Doppler ultrasound method [23]; the other four used the oscillometric technique to achieve the results [11,24,25,26]. Four studies performed functional echocardiography during neonatal transition (table 4) [11,12,20,25]; two in addition to BP monitoring [11,25] and three in addition to HR monitoring [11,12,20]. …”

Section: Resultsmentioning

confidence: 99%

“…However, the reported difference in LVO and LVSV might be explained by the use of different techniques between the studies. In addition, shunting through a persistent ductus arteriosus has been described, becoming increasingly more left to right during the first 10 min after birth [12,20]. …”

Section: Discussionmentioning

confidence: 99%

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Cardiocirculatory Monitoring during Immediate Fetal-to-Neonatal Transition: A Systematic Qualitative Review of the Literature

Baik

Urlesberger²,

Schwaberger³

et al. 2014

Neonatology

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Background: The fetal-to-neonatal transition is a complex process that includes changes in cardiac and respiratory systems. Objective: The aim of this study is to review the different methods of cardiocirculatory monitoring during the immediate neonatal transition period. Methods: A systematic search of PubMed and Ovid Embase was performed using the following terms: infant, newborn, newborn infant, neonate, neonates, heart, cardiac, blood pressure, haemodynamic, hemodynamics, blood circulation, circulation, echocardiography, ultrasonography, sonography, electrocardiography, ECG, oximetry, pulse, pulse oximetry, monitoring, measurement, acclimatization, adaptation, transition, after birth and delivery room. Additional articles were identified by manual search of cited references. Only human studies describing cardiocirculatory monitoring during the first 15 min after birth were included. Results: Thirteen studies were identified that described heart rate (HR). Additional five studies were identified that measured blood pressure. Four studies performed functional echocardiography during neonatal transition; two in addition to blood pressure monitoring and three in addition to HR monitoring. Conclusion: Routine HR monitoring using electrocardiography or pulse oximetry is used to evaluate adequate hemodynamic transition, and reference ranges have been established. Measuring blood pressure noninvasively though noncontinuously might be of some value in future, considering that the normative data have been established recently. Echocardiographic monitoring during the immediate transition period will improve the knowledge about cardiac function changes, but introduction in clinical routine remains questionable. © 2014 S. Karger AG, Basel

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

See 3 more Smart Citations

Cardiocirculatory Monitoring during Immediate Fetal-to-Neonatal Transition: A Systematic Qualitative Review of the Literature

Baik

Urlesberger²,

Schwaberger³

et al. 2014

Neonatology

View full text Add to dashboard Cite

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Perfusion index and left ventricular output correlation in healthy term infants

et al. 2017

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PI is significantly correlated with LVO in healthy term infants. These results support the theoretical potential role of PI in the CHD screening. What is Known: • Perfusion index is an indirect measure of perfusion which depends on cardiac output and peripheral vascular resistance whose normal values have been documented in term and preterm infants in the first days of life. • Perfusion index has been proposed for the screening of congenital heart disease with duct-dependent systemic circulation in term infants. What is New: • Perfusion index shows a significant correlation with the left ventricular output in term infants at the moment of the screening for congenital heart disease. • Perfusion index might have a theoretical role in improving the accuracy of pulse oximetry in the screening of CHD associated to low systemic flow.

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The effect of breathing on ductus arteriosus blood flow directly after birth

et al. 2017

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Spontaneous breathing at birth influences ductus arteriosus (DA) flow. This study quantifies the effect of breathing on DA shunting directly after birth. In healthy term infants born by elective cesarean section, simultaneous measurements of DA shunting and tidal volumes during spontaneous breathing were performed at 2–5, 5–8, and 10–13 min after birth. Eight infants with a mean (SD) gestational age of 40 (1) weeks and 3216 (616) grams were studied. Inspiratory tidal volume was 5.8 (3.3–7.7), 5.7 (4.0–7.1), and 5.2 (4.3–6.1) mL/kg at 2–5, 5–8, and 10–13 min. The velocity time integral of left-to-right shunting significantly increased during inspiration when compared to expiration (8.4 (5.2) vs. 3.7 (2.3) cm, 8.9 (4.4) vs. 5.6 (3.4) cm, and 14.0 (6.7) vs. 8.4 (6.9) cm; all p < 0.0001) at 2–5, 5–8, and 10–13 min, respectively. In contrast, right-to-left shunting was not different between inspiration and expiration at 2–5 and 10–13 min (11.1 (2.4) vs. 11.1 (2.6) cm and 10.7 (2.3) vs. 10.6 (3.0) cm; p > 0.05), but there was a small increase at 5–8 min (12.1 (2.4) vs. 10.8 (2.9) cm; p = 0.001) during expiration. Conclusion: Directly after birth, ductal shunting is influenced by breathing effort, predominantly with an increase in left-to-right shunt due to inspiration. What is Known: • Spontaneous breathing at birth influences ductus arteriosus flow and pulmonary blood flow.• Crying causes a significant increase in left-to-right ductus arteriosus shunting. What is New: • Left-to-right ductus arteriosus shunting increases during inspiration compared to expiration.• Breathing is important for ductal shunting and contributes to pulmonary blood flow.

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Non-invasive measurements of ductus arteriosus flow directly after birth

Abstract: DA shunting changes swiftly from predominantly right-to-left shunting to predominantly left-to-right shunting at 10 min after birth, reflecting differential changes in pulmonary and systemic vascular resistance.

Cited by 41 publications

References 26 publications

Cardiocirculatory Monitoring during Immediate Fetal-to-Neonatal Transition: A Systematic Qualitative Review of the Literature

Cardiocirculatory Monitoring during Immediate Fetal-to-Neonatal Transition: A Systematic Qualitative Review of the Literature

Perfusion index and left ventricular output correlation in healthy term infants

The effect of breathing on ductus arteriosus blood flow directly after birth

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