Premium
The relation between inferior vena cava oxygen saturation, superior vena cava flow, fractional oxygen extraction and haemoglobin affinity in sick newborns: A pilot study
Author(s) -
Hart James,
Vemgal Prakash,
CocksDrew Sandra,
Harrison Catherine,
Andersen Chad
Publication year - 2006
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.1651-2227.2006.tb02179.x
Subject(s) - medicine , superior vena cava , inferior vena cava , gestational age , oxygen saturation , oxygen delivery , arteriovenous oxygen difference , oxygen , blood flow , anesthesia , cardiology , saturation (graph theory) , heart rate , stroke volume , blood pressure , pregnancy , chemistry , genetics , organic chemistry , biology , mathematics , combinatorics
Aim: To determine whether inferior vena cava oxygen saturation (UvO 2 ) or lower‐body fractional oxygen extraction (FOE) could detect poor cardiac output in newborns. Methods: UvO 2 and arterial oxygen saturation (SaO 2 ) were measured simultaneously with echocardiographic determination of superior vena cava blood flow (SVC flow) at <12, 12–24 and >24 h. Haemoglobin concentration ([Hb]), haemoglobin oxygen affinity (HOA) and lactate were measured and FOE calculated. Results: 56 studies in 17 infants, gestational age (median (range)) 26 wk 4 d (23 wk 2 d–42 wk 3 d): UvO 2 (mean (SD)) was 84.9% (5.0), 77.6% (9.2) and 81.7% (12.9) at <12, 12–24 and >24 h, respectively; SVC flow (mean (SD)) increased from 71.7 (33) to 85 (66) and 123 (88) ml/kg/min at <12, 12–24 and >24 h, respectively. Despite a fall in mean [Hb], mean upper‐body oxygen delivery increased due to increases in both SVC flow and arteriovenous content difference. There was a negative correlation between [Hb] and FOE. Infants with high HOA had significantly lower FOE. Conclusion: Measurement of UvO 2 is feasible in newborns. Changes to SVC flow and arteriovenous content difference lead to improvements in oxygen delivery. The interaction of HOA warrants further study.