ECHOCARDIOGRAPHIC ASSESSMENT OF SUPERIOR VENA CAVA FLOW IN TERM AND PRETERM NEONATES

Abstract

Background: Despite significant advances in our ability to monitor complex and clinically relevant hemodynamic parameters, in most neonatal intensive care units (NICUs), cardiovascular function is assessed only by continuous heart rate, invasive blood pressure monitoring, and poorly validated clinical signs such as capillary refill time. Indirect measures for assessment of tissue perfusion, including urine output and serum lactate levels, are especially problematic with the very early preterm neonate in the first postnatal days when complex hemodynamic changes occur during the transition to postnatal life. Functional echocardiography can provide a direct assessment of hemodynamics on bedside, and may be considered as an extension of the clinical examination to evaluate cardiovascular wellbeing in the critically-ill infant. Objectives: The study is designed to assess the superior vena cava flow in normal term, preterm and low birth weight. Patients and Methods: This is a case control study of 50 patient were selected and divided into three groups: full term, preterm and low birth weight. In each patient we measured SVC maximum, minimum, mean dimension from parasternal view while velocity time integral measured from subcostal view and calculate SVC flow from the formula. Results: We found that significant decrease in SVC max, SVC min, SVC mean and SVC flow of preterm and low birth weight groups, compared to control group. While VTI was significant decrease in preterm group, compared to control group, but low birth weight was show non-significant decrease, compared to control group. And a significant decrease in gestational age, Apgar score, weight and length of preterm and low birth weight groups, compared to control group. But there was non-significant difference in heart rate, respiratory rate and capillary refill time in both preterm and low birth weight groups, compared to control group. Systolic and diastolic blood pressure show significant decrease in the mentioned groups, compared to control group. Conclusion: Measurement of SVC flow is important for assessment of hemodynamic status in full term, preterm and low birth weight neonates.