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Effects of volume expansion on cardiac output in the preterm infant
Author(s) -
Pladys P.,
Wodey E.,
Bétrémieux P.,
Beuchée A.,
Ecoffey C.
Publication year - 1997
Publication title -
acta pædiatrica
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.772
H-Index - 115
eISSN - 1651-2227
pISSN - 0803-5253
DOI - 10.1111/j.1651-2227.1997.tb14854.x
Subject(s) - medicine , hypovolemia , cardiac output , ductus arteriosus , cardiac index , vascular resistance , mean arterial pressure , anesthesia , blood volume , volume expansion , hemodynamics , blood pressure , mean circulatory filling pressure , cardiology , central venous pressure , heart rate
Clinical and echocardiography haemodynamic evaluations of response to volume expansion are described in 12 preterm neonates aged < 7days presenting without cardiac dysfunction and with a low cardiac output. They received 10% albumin solution (20 ml kg ‐1 ) for 3h. Measurements were made before infusion, at volumes 5, 12. 5 and 20 ml kg ‐1 and 1 h later. All infants increased significantly their cardiac output (CO) (from a median of 177 to 283 ml kg ‐1 min ‐1 ). The rise of CO decreased with the volume infused. The index of systemic vascular resistance (SVR = ratio of mean arterial pressure to the CO) decreased for the six patients without PDA (from 272 to 193 mmHg 1 ‐1 kg ‐1 min ‐1 , p < 0. 05) showing that the hypovolemic preterm infant is able to shut down peripherally in response to hypovolemia. The four hypotensive infants responded by increasing mean arterial blood pressure (from 29 to 44 mmHg). Cutaneous refilling time decreased during infusion (from 6. 7 to 3. 8 s, p < 0. 01). One infant had an haemodynamically significant ductus arteriosus revealed by volume expansion, another one developed myocardial dysfunction.