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Cerebral tissue oxygenation index and superior vena cava blood flow in the very low birth weight infant
Author(s) -
Moran M,
Miletin J,
Pichova K,
Dempsey EM
Publication year - 2009
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.1651-2227.2008.01006.x
Subject(s) - medicine , oxygenation , superior vena cava , cerebral blood flow , cardiology , birth weight , prospective cohort study , low birth weight , anesthesia , pregnancy , biology , genetics
Background: Superior vena cava (SVC) flow assesses blood flow from the upper body, including the brain. Near infrared spectroscopy (NIRS) provides information on brain perfusion and oxygenation. Aim: To assess the relationship between cerebral tissue oxygenation index (cTOI) and cardiac output measures in the very low birth weight (VLBW) infant in the first day of life. Methods: A prospective observational cohort study. Neonates with birth weight less than 1500 g (VLBW) were eligible for enrollment. Newborns with congenital heart disease, major congenital malformations and greater than Papile grade1 Intraventricular Haemorrhage on day 1 of life were excluded. Echocardiographic evaluation of SVC flow was performed in the first 24 h of life. Low SVC flow states were defined as a flow less than 40 mL/kg/min. cTOI was measured using NIRO 200 Hamamatsu. Results: Twenty‐seven VLBW neonates had both echocardiography and NIRS performed. The median (range) gestation was 29/40 (25 + 3 to 31 + 5 weeks) and median birth weight was 1.2 kg (0.57–1.48 kg). The mean (SD) TOI was 68.1 (7.9)%. The mean (SD) SVC flow was 70.36(39.5) mLs/kg/min. The correlation coefficient of cerebral tissue oxygenation and SVC flow was r = 0.53, p‐value 0.005. There was a poor correlation between right and left ventricular output and cTOI which is not surprising considering the influence of intra‐ and extracardiac shunts. Conclusion: There is a positive relationship between cerebral TOI values and SVC flow in the very low birth infant on day one of life.