Abstract
Phototherapy (PT) is known to increase peripheral blood flow in neonates, but information on the associated cardiovascular effects is not available. Using pulsed Doppler echocardiography we evaluated cardiac output (CO) and stroke volume (SV) in 12 preterm (BW±SD 2264±425 g, GA 35.2±1.4 w) and 13 term (BW 3161±488 g, GA 39.0±1.7 w) neonates with and without PT. We concomitantly measured arterial limb blood flow by strain gauge plethysmography and skin blood flow by photoplethysmography.
The results show that with PT CO fell by 6% (from 261±37 to 246±30 ml/min/kg, p<0.02) due to reduced SV (from 1.85±0.32 to 1.67±0.29 ml/kg, p<0.005). Heart rate increased only slightly (from 143±16 to 149±17/min, NS). Skin blood flow increased by 54% (p<0.005) in the preterm and by 27% (p<0.005) in the term infants, total limb blood flow increased by 68% (p<0.05) in the preterm and by 38% (p<0.05) in the term infants. The reduced SV during PT is probably an expression of reduced physical activity of the newborn.
We conclude that (1) CO decreases during PT due to reduced SV, (2) skin blood flow increases during PT with the increments tending to be higher in preterm than in term infants. We speculate that this effect may lead to redistribution of blood flow and has the potential for compromising tissue perfusion in sick newborns with reduced CO.
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Walther, F., Wu, P. & Siassi, B. 1558 CARDIAC OUTPUT CHANGES IN NEONATES WITH HYPERBILIRUBINEMIA TREATED WITH PHOTOTHERAPY. Pediatr Res 19, 370 (1985). https://doi.org/10.1203/00006450-198504000-01582
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DOI: https://doi.org/10.1203/00006450-198504000-01582