Journal article
Assessment of superior vena cava flow and cardiac output in different patterns of patent ductus arteriosus shunt
Echocardiography (Mount Kisco, N.Y.), Vol.38(9), pp.1524-1533
09/2021
DOI: 10.1111/echo.15163
PMID: 34309068
Abstract
Background
Despite the widespread use of superior vena cava (SVC) flow as a marker of systemic blood flow from the upper body, no previous studies have systematically evaluated the correlation between SVC flow and other echocardiography measures of systemic blood flow in the context of different patterns of patent ductus arteriosus (PDA) shunt direction
Methods
A retrospective cohort study of preterm infants (< 30 weeks, < 21 days of life) who underwent comprehensive targeted neonatal echocardiography (TnECHO) was performed. Patients were categorized as follows: (i) Hemodynamically significant left‐to‐right shunt; (ii): Bidirectional shunt; (iii) No PDA or insignificant shunt. SVC flow, as measured by two distinct methods, was compared to left and right ventricular outputs (LVO and RVO). Intra‐ and inter‐observer reliability testing was performed
Results
In total, 45 patients were included (15 in each group) with a median [IQR] weight of 720 [539, 917] grams at the time of assessment. SVC dimensions and flow measurements were not different between the groups, although patients with left‐to‐right shunt had higher LVO/RVO ratio. SVC flow, as estimated using the modified method, had a strong correlation with LVO (r = .63, p = 0.012) and RVO (r = .635, p = 0.011) in patients with no PDA. Inter‐ and intra‐observer reliability were both stronger for LVO and RVO when compared to SVC flow measurements
Conclusion
SVC flow was comparable across all three groups irrespective of higher LVO and LVO/RVO ratio in patients with left‐to‐right shunts. This may reflect poor measurement reliability or compensation for left‐to‐right ductal shunt by increased LVO to maintain systemic perfusion.
Details
- Title: Subtitle
- Assessment of superior vena cava flow and cardiac output in different patterns of patent ductus arteriosus shunt
- Creators
- Adrianne Rahde Bischoff - University of IowaRegan E. Giesinger - University of IowaAmy H. Stanford - University of IowaRavi Ashwath - University of IowaPatrick J. McNamara - University of Iowa
- Resource Type
- Journal article
- Publication Details
- Echocardiography (Mount Kisco, N.Y.), Vol.38(9), pp.1524-1533
- DOI
- 10.1111/echo.15163
- PMID
- 34309068
- ISSN
- 0742-2822
- eISSN
- 1540-8175
- Number of pages
- 10
- Language
- English
- Date published
- 09/2021
- Academic Unit
- Radiology; Stead Family Department of Pediatrics; Neonatology; Internal Medicine
- Record Identifier
- 9984354156902771
Metrics
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