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Integrated evaluation of hemodynamics: a novel approach for the assessment and management of preterm infants with compromised systemic circulation

Journal of Perinatology volume 38, pages 1337–1343 (2018)Cite this article

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Abstract

Objective

To establish normal reference values for tissue oxygen delivery and consumption in preterm infants and demonstrate the usefulness of the integrated evaluation of hemodynamics (IEH) in preterm infants with compromised systemic circulation (CSC).

Methods

This study included 32 stable preterm infants and 6 infants (selected cases) who underwent IEH. IEH is a multimodal approach which integrates clinical parameters: data obtained from near-infrared spectroscopy (NIRS) and targeted neonatal echocardiography (TNE).

Results

Thirty-two hemodynamically stable preterm infants underwent 57 IEH studies. The mean (10th and 90th percentiles) were 0.23 (0.14 and 0.29) for cerebral fractional oxygen extraction (crFOE), 0.2 (0.13 and 0.24) for renal fractional oxygen extraction (rnFOE), and 0.22 (0.19 and 0.27) for mesenteric fractional oxygen extraction (msFOE). The time to full clinical recovery in all sick infants after the change of management was between 4 and 48 h.

Conclusion

IEH was useful in targeting the management of preterm infants with CSC.

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Authors and Affiliations

  1. Section of Neonatology, University of Manitoba, Winnipeg, Manitoba, Canada

    Yasser N. Elsayed, Deepak Louis, Yaser H. Ali, Reem Amer & Mary M. Seshia

  2. Departments of Pediatrics and Physiology, Division of Neonatology, Hospital for Sick Children, Toronto, ON, Canada

    Patrick J. McNamara

Authors
  1. Yasser N. Elsayed
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  2. Deepak Louis
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  3. Yaser H. Ali
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  4. Reem Amer
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  5. Mary M. Seshia
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  6. Patrick J. McNamara
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Corresponding author

Correspondence to Yasser N. Elsayed.

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The authors declare that they have no conflict of interest.

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Elsayed, Y.N., Louis, D., Ali, Y.H. et al. Integrated evaluation of hemodynamics: a novel approach for the assessment and management of preterm infants with compromised systemic circulation. J Perinatol 38, 1337–1343 (2018). https://doi.org/10.1038/s41372-018-0188-6

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