Abstract
Transient myocardial dysfunction (TMD) secondary to perinatal asphyxia is an important cause of neonatal morbidity. To determine cardiac output (CO) and stroke volume (SV) in TMD we evaluated 11 newborns with severe perinatal asphyxia: mean (±SD) BW 3.0±1.2 kg, GA 36.6±5.3 weeks, initial pH 6.90±0.08, and initial mean arterial BP 39±10 mmHg. TMD was diagnosed by M-mode echocardiography in the presence of abnormal left ventricular (LV) shortening fraction (SID), LV systolic time interval and/or left atrial/aortic ratio.
Using pulsed Doppler echocardiography, we found mean CO to be 122±28 ml/min/kg (normal: 249±34 ml/min/kg) and SV to be 0.82± 0.21 ml/kg (normal: 1.77±0.28 ml/kg). Six newborns were treated with dopamine (4-10 μg/kg/min). Mean arterial BP increased from 38±8 to 57±7 mmHg (p<0.001), CO from 114±26 to 201±39 ml/min/kg (p<0.001), SV from 0.80±0.19 to 1.26±0.14 ml/kg (p<0.001), and heart rate from 144±6 to 159±21 beats/min (p<0.05) within one hour. The SID normalized quickly and the other echocardiographic abnormalities resolved over a 24-48 hour period.
We conclude that CO is low in TMD caused by asphyxia, and that dopamine treatment rapidly improves CO by increasing SV. Serial measurements of CO can be useful for monitoring dopamine treatment in newborns with cardiovascular compromise.
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Walther, F., Siassi, B., Ramadan, N. et al. 154 CARDIAC OUTPUT IN NEWBORNS WITH TRANSIENT MYOCARDIAL DYSFUNCTION SECONDARY TO PERINATAL ASPHYXIA. Pediatr Res 19, 136 (1985). https://doi.org/10.1203/00006450-198504000-00184
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DOI: https://doi.org/10.1203/00006450-198504000-00184