Abstract
Diuresis is impaired in preterm infants with severe respiratory distress syndrome (RDS). We measured renal blood flow velocity (RBFV) in the right renal artery (RRA) in 42 ventilated preterm infants <32 wks gestation: 32 with severe RDS and 10 without RDS. RBFV and cardiac output were determined with 2D/pulsed Doppler ultrasound between 24-36 h after birth. Mean arterial blood pressure and heart rate were recorded simultaneously from an indwelling umbilical artery line. Prior to the ultrasound measurements arterial blood gases, hematocrit, and mean airway pressure (MAP) were determined. Peak systolic, end diastolic, and mean flow velocities in the RRA were calculated. Infants with severe RDS had a significantly lower mean flow velocity in the RRA than the controls (19.9 ± 0.4 [mean ± SD] vs 23.2 ± 0.9 cm/sec; p<0.002). Stepwise regression analysis showed that this reduction in RBFV was primarily determined by a higher MAP and lower cardiac output. We speculate that a high MAP in infants with severe RDS increases intrathoracic pressure, leading to a reduced venous return and lower cardiac output and blood pressure. This may explain our finding of a reduced mean blood flow velocity in the right renal artery in preterm infants with severe RDS.
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Van De Bor, M., Van Bel, F., Guit, G. et al. 22 RENAL BLOOD PLOW VELOCITY IU PRETERM INFANTS WITH SEVERE RESPIRATORY DISTRESS SYNDROME. Pediatr Res 28, 280 (1990). https://doi.org/10.1203/00006450-199009000-00046
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DOI: https://doi.org/10.1203/00006450-199009000-00046