title: The Impact of Integrated Evaluation of Hemodynamics on Management of Preterm Infants with Late-Onset Compromised Systemic Circulation.
abstract: ObjectivesTo study the impact of integrated evaluation of hemodynamics (IEH), using targeted neonatal echocardiography (TNE), cerebral regional tissue oxygenation (crRTO), and fractional oxygen extraction (FOE), using near-infrared spectroscopy (NIRS) on the management of infants with late-onset compromised systemic circulation (LCSC), and evaluation of the hemodynamic characteristics.Study DesignRetrospective cohort study comparing infants with LCSC who underwent IEH (April 2014 to May 2016) with an earlier EPOCH who did not undergo IEH (January 2012 to March 2014). The primary outcome was the time to recovery.ResultsTotal 43 infants were included; 18 infants underwent IEH with a median (IQR) 2 (1-3) assessments per infant. The time to recovery was shorter in IEH group with a median (IQR) 28 hours (15-62) compared with non-IEH group 96 hours (30-160). Autoregulation was compromised in 50%, and systemic vascular resistance (SVR) was low in 67%.ConclusionIEH was associated with shorter time to recovery in infants with LCSC.
authors.affiliation: Section of Neonatology, Department of Paediatrics, University of Manitoba, Winnipeg, Manitoba, Canada.
authors.forename: Reem
authors.initials: R
authors.lastname: Amer
authors.affiliation: Section of Neonatology, Department of Paediatrics, University of Manitoba, Winnipeg, Manitoba, Canada.
authors.forename: Reem
authors.initials: R
authors.lastname: Kalash
authors.affiliation: Section of Neonatology, Department of Paediatrics, University of Manitoba, Winnipeg, Manitoba, Canada.
authors.forename: Mary M
authors.initials: MM
authors.lastname: Seshia
authors.affiliation: Section of Neonatology, Department of Paediatrics, University of Manitoba, Winnipeg, Manitoba, Canada.
authors.forename: Yasser N
authors.initials: YN
authors.lastname: Elsayed
mesh_terms: D000140:Acidosis, Lactic / Q000209:etiology; D002302:Cardiac Output; D002318:Cardiovascular Diseases / Q000150:complications / Q000503:physiopathology* / Q000628:therapy; D002319:Cardiovascular System / Q000503:physiopathology*; D054022:Cerebrum / Q000378:metabolism; D004452:Echocardiography; D005260:Female; D005865:Gestational Age; D006439:Hemodynamics; D006706:Homeostasis; D006801:Humans; D007022:Hypotension / Q000209:etiology; D007231:Infant, Newborn; D007234:Infant, Premature / Q000502:physiology*; D000067562:Late Onset Disorders / Q000503:physiopathology*; D008297:Male; D009846:Oliguria / Q000209:etiology; D010092:Oximetry; D010100:Oxygen / Q000378:metabolism; D020127:Recovery of Function; D012189:Retrospective Studies; D019265:Spectroscopy, Near-Infrared; D013997:Time Factors; D014655:Vascular Resistance
chemical_list: D010100:Oxygen