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.
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Change history
15 April 2019
A correction to this paper has been published and can be accessed via a link at the top of the paper.
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Acknowledgements
We thank the parents and clinicians who gave their support to the conduct of the study, as well as Rebecca Brown for assistance with data management.
Funding
National Health and Medical Council project grant 571309
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H.P. participated in study design, patient recruitment, data analysis, data interpretation, and drafted the initial manuscript. K.P.R. participated in study design, data collection, and data analysis. A.K. participated in study design, data collection, and data analysis. L.S. supervised the project design and participated in data collection. N.E. participated in the design of the study and participated in patient recruitment and data acquisition. A.G. participated in the design of the study and participated in patient recruitment and data acquisition. M.K. participated in the design of the study and participated in patient recruitment and data acquisition. S.S. participated in patient recruitment and data acquisition. K.d.W. participated in the design of the study and participated in patient recruitment and data acquisition. W.T.-M. conceptualized and designed the study and participated in data analysis and interpretation. D.O. conceptualized and designed the study, participated in patient recruitment, data analysis and interpretation, and drafted the initial manuscript. All authors revised it critically for important intellectual content, approved the final manuscript as submitted, and agreed to be accountable for all aspects of the work.
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Popat, H., Robledo, K.P., Kirby, A. et al. Associations of measures of systemic blood flow used in a randomized trial of delayed cord clamping in preterm infants. Pediatr Res 86, 71–76 (2019). https://doi.org/10.1038/s41390-019-0348-1
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DOI: https://doi.org/10.1038/s41390-019-0348-1
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