Abstract
Aim: To determine the hemodynamic patterns in preterm neonates with respiratory distress syndrome (RDS) using the USCOM-1A technology.
 Materials and Methods: The USCOM device is a bedside method of evaluating cardiac output (CO) based on continuous-wave Doppler ultrasound. Hemodynamic parameters were measured daily for 7 days in 32 preterm neonates 32 ± 1 weeks of gestation (1688 ± 111 g) with RDS requiring noninvasive respiratory support (NCPAP, NIPPV, HFNC) and no catecholamine support in comparison with 28 healthy term neonates (3100 ± 690 g).
 Results: At day 1, preterm neonates had lower SVI (18 ± 5 vs 28 ± 8 ml m-2, p = 0.043) and higher SVRI (1585 ± 245 vs 1035 ± 358 dyn s cm-5 m2, p = 0.013) with a tendency for lower cardiac index (2.6 ± 0.8 vs 4.0 ± 1.3 l min-1 m-2, p = 0.089). Together with no difference in SMII, it indicates the presence of diastolic dysfunction with low preload. It is noted that all parameters had not changed by day 7 in preterm neonates, whereas term neonates demonstrated significantly increased SMII reflecting postnatal cardiovascular adaptation. Compared with preterm neonates with RDS requiring NCPAP/NIPPV, preterm neonates requiring HFNC had higher levels of FTc (330 ± 59 vs 388 ± 41 ms, р = 0.045), SVI (13 ± 3 vs 18 ± 4, ml/m2, р = 0.007), SMII (0.41 ± 0.09 vs 0.57 ± 0.21, р = 0.02), and CI (2.2 ± 0.6 vs 4.5 ± 0.9 l/min/m2, р = 0.006).
 Conclusions:Noninvasive respiratory support in preterm neonates with RDS may lead to diastolic dysfunction that is less prominent in neonates with HFNC.
Highlights
Ключевые слова: новорожденные дети; синдром дыхательных расстройств; кардиореспираторные взаимоотношения; постоянное положительное давление в дыхательных путях; неинвазивная респираторная поддержка; сердечный выброс; ультразвуковой монитор сердечного выброса
Together with no difference in SMII it indicates to the presence of diastolic dysfunction with low preload
It is detected that all parameters had not changed by the day 7 in preterm neonates whereas term neonates demonstrated significantly increased SMII that can reflect postnatal cardiovascular adaptation
Summary
Ключевые слова: новорожденные дети; синдром дыхательных расстройств; кардиореспираторные взаимоотношения; постоянное положительное давление в дыхательных путях; неинвазивная респираторная поддержка; сердечный выброс; ультразвуковой монитор сердечного выброса. Цель исследования: оценить влияние неинвазивной респираторной терапии (НРТ) на показатели центральной гемодинамики (ЦГ), измеренные с помощью ультразвукового монитора сердечного выброса (USCOM) у недоношенных детей с синдромом дыхательных расстройств (СДР).
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