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The Relationship between blood pressure parameters and left ventricular output in neonates

Journal of Perinatology volume 39, pages 619–625 (2019)Cite this article

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Abstract

Objective

To evaluate the relationship between systolic (SBP), diastolic (DBP), mean (MBP) blood pressures and pulse pressure (PP), and left ventricular output (LVO), a surrogate of systemic blood flow.

Study design

This retrospective study included neonates who underwent targeted neonatal echocardiography (TNE) in 3-tertiary NICUs over 2 years. Associations between LVO and BP components were investigated. Analysis was adjusted for relevant covariates.

Result

1060 studies from 485 neonates were included, with a mean GA of 28.4 ± 4.6 weeks and birth weight of 1234 ± 840 grams. LVO was associated positively with SBP and PP, and negatively with GA. PP demonstrated the highest predictive value for identifying infants with LVO < 150 ml/kg/min (area under the curve 0.75 [95% CI 0.68, 0.82]). MBP and DBP demonstrated no correlation with LVO.

Conclusion

BP parameters correlate poorly with LVO, irrespective of GA and underlying etiology. Narrow PP may be more reflective of low LVO than low SBP.

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Acknowledgements

The authors would like to acknowledge Dr. Kin Fan Young Tai, staff neonatologist at Mount Sinai Hospital, for her intellectual contribution to the study analysis.

Funding

The authors have no relevant financial relationships to disclose.

Author contribution

Drs. Kharrat and Jain conceptualized and designed the study, designed the data collection instruments, carried out the data extraction, drafted the initial manuscript, and approved the final manuscript as submitted. Dr. Ibarra Rios reviewed the study protocol and contributed to its design, carried out data extraction, reviewed and revised the manuscript, and approved the final manuscript as submitted. Drs. Weisz, Giesinger, Groves, and McNamara reviewed the study protocol and contributed to its design, critically reviewed and revised the manuscript, and approved the final manuscript as submitted. Mr. Yang reviewed the study protocol and contributed to its design, performed the statistical analysis, and approved the final manuscript as submitted. Dr. Shah critically reviewed the study protocol and contributed to its design, reviewed the extracted data and statistical analysis, critically reviewed and revised the manuscript, and approved the final manuscript as submitted.

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Authors and Affiliations

  1. Department of Paediatrics, University of Toronto, Toronto, ON, Canada

    Ashraf Kharrat, Dany E. Weisz, Regan E. Giesinger, Patrick J. McNamara, Prakesh S. Shah & Amish Jain

  2. Neonatology Department, Hospital Infantil de México Federico Gómez, National Institute of Health, Mexico City, Mexico

    Daniel Ibarra Rios

  3. Newborn and Developmental Paediatrics, Sunnybrook Health Sciences Centre, Toronto, ON, Canada

    Dany E. Weisz

  4. Division of Neonatology, The Hospital for Sick Children, Toronto, ON, Canada

    Regan E. Giesinger & Patrick J. McNamara

  5. Department of Pediatrics, Icahn School of Medicine at Mount Sinai, New York, NY, USA

    Alan Groves

  6. MiCare Research Center, Mount Sinai Hospital, Toronto, ON, Canada

    Junmin Yang & Prakesh S. Shah

  7. Department of Paediatrics and Lunenfeld-Tanenbaum Research Institute, Mount Sinai Hospital, Toronto, ON, Canada

    Prakesh S. Shah & Amish Jain

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  1. Ashraf Kharrat
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  8. Prakesh S. Shah
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  9. Amish Jain
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Correspondence to Amish Jain.

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Kharrat, A., Rios, D.I., Weisz, D.E. et al. The Relationship between blood pressure parameters and left ventricular output in neonates. J Perinatol 39, 619–625 (2019). https://doi.org/10.1038/s41372-019-0337-6

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