Abstract
30 newborns with clinical evidence of PTC and structrally normal hearts underwent estimation of left ventricualr output (LVO) using Doppler echocardiography, shortly after presentation. Results of survivors were compared with non-survivors.
Study Group 14 babies were at term (birth weight 2585-4390 g) and 16 were pre-term (26-36 weeks, 855-4615 g) Age at examination was 1 to 72 hours, median 20 hours Underlying diagnose were hyaline membrane disease (12), asphyxdia (10), meconium aspiration (2), maternal diabetes (1), hydrops (1) and hypoplastic lungs (1) 3 babies had no obvious cause (“PFC”) 27 babies were ventilated
Results Values can be compared with 10th-90th centile ranges from healthy newborns in the first 72 hours of life (LV output 166-248 mls/kg/min. LV stroke volume, indexed by body weight (SVI) 1.2.19 mk/kg) 12 of the 30 babies died 19-478 hours (median 25 hrs) after the examination 2 early deaths were due to severe pulmonary interstitial emphysema and not attributable to PTC and are excluded from this analysis:
4 babies had LVO < 100 mls/kg/min, and all 4 died. 6/7 babies with SVI < 1 ml/kg died.
Conclusion Low LVO and SVI predicted subsequent death in babies with SVI <1ml/kg died, worthy of further prospective evaluation The close link to outcome is probably because these are both reduced by a reduction in pulmonary venous return and/or myocardial performance and hypovolaemia, all of which are features of severe disease.
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Skinner, J., Hunter, S. & Hey, F. Low left ventricular output prediets fatal outcome in babies with persistent transitional Circulation (PTC). Pediatr Res 35, 278 (1994). https://doi.org/10.1203/00006450-199402000-00144
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DOI: https://doi.org/10.1203/00006450-199402000-00144