Haemodynamics edition of seminars in fetal and neonatal medicine

Abstract

Haemodynamics or the movement of blood is vital to life and yet, even in adults, it is surprisingly difficult to study. In neonatology and fetal medicine these problems are amplified several times by the pragmatic issues of small size in neonates and both small size and lack of direct access in fetal medicine. In neonatology, we’re good at direct measures of pressure and oxygen levels in the blood stream but have limited means with which to measure the most important determinant of tissue oxygen delivery, which is blood flow. In fetal medicine, even these parameters cannot be measured directly. Both specialties are dependent on indirect measurement methodologies and considerable research efforts have gone into using these methods to understand haemodynamic pathophysiology in the fetus and newborn and, in both areas, there is considerable mechanistic evidence linking such haemodynamic pathology with end organ injury. In this edition, we have taken a methodology-based view of haemodynamics. We’ve asked recognised experts to describe how each method works, to review what’s been discovered to date and define the potential for further research and clinical application.