Background. Doppler ultrasonography is mandatory in the evaluation of neonatal cardiogenic shock and offers a reliable non invasive estimate of CO. Objective: to evaluate the haemodynamic aspects of 45 newborn infants affected by cardiogenic shock. Design: prospective, correlation study of haemodynamic measurements by Doppler ultrasound parameters and mortality rate. Setting: Neonatal Intensive Care, Tertiary Care Center. Patients: 45 newborn infants with cardiogenic shock [G.A 37 (34-41) wks, BW 2750 (1600-3600) g], and a control group of 20 neonates [G.A 38 (34-40) wks, BW 2960 (1750-3800) g].Measurements: CO was measured by Pulsed Color Doppler Ecocardiography (Vingmed CFM 750) during the first 24 hrs of life and at 48 hrs (median 26 hrs, range 0.8-48 hrs) using a suprasternal approach for measurement of blood flow velocity and M-Mode trailing edge to leading edge echocardiography for aortic diameter. Statistical evaluation: data collected are given as medians and interquartile range. Statistical analysis of medians was carried out using the Mann-Withney U test; p < 0.05 was considered significant. Results: in the healthy subjects the CO was 240 mL/min/kg (210-280), while in the shock group CO was 170 mL/min/kg(130-200), p < 0.01. In the shock group, 29 infants had persistently CO≤ 150 mL/min/kg and 5 of them (17.2%) died; 16 neonates had CO > 150 mL/min/kg and only one (8.3%) died (p < 0.01). Conclusions: persistently low CO (≤ 150 mL/min/kg) during the first 48hrs of life, in newborn infants with cardiogenic shock is associated with a significantly higher mortality.
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Sabatino, G., Gerboni, S., Ramenghi, L. et al. PERSISTENTLY LOW CARDIAC OUTPUT (CO) DURING THE FIRST 48 HOURS OF LIFE PREDICTS HIGH MORTALITY IN NEWBORN INFANTS WITH CARDIOGENIC SHOCK. 200. Pediatr Res 39 (Suppl 4), 36 (1996). https://doi.org/10.1203/00006450-199604001-00219
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DOI: https://doi.org/10.1203/00006450-199604001-00219