Relationship between cerebral oxygenation, cardiac output, and blood pressure during transitional period in extremely low gestational age neonates

Poorva Deshpande; Caio Barbosa de Olivera; Amish Jain; Cecil Hahn; Prakesh S. Shah; Anne-Marie Guerguerian; Patrick J. McNamara

doi:10.3389/fped.2023.1187769

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Relationship between cerebral oxygenation, cardiac output, and blood pressure during transitional period in extremely low gestational age neonates

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Relationship between cerebral oxygenation, cardiac output, and blood pressure during transitional period in extremely low gestational age neonates

Poorva Deshpande, Caio Barbosa de Olivera, Amish Jain, Cecil Hahn, Prakesh S. Shah, Anne-Marie Guerguerian and Patrick J. McNamara

Frontiers in pediatrics, Vol.11, 1187769

08/01/2023

DOI: 10.3389/fped.2023.1187769

PMCID: PMC10466030

PMID: 37654688

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Abstract

ObjectiveTo describe the relationship between cerebral oxygenation, cardiac output, arterial blood pressure (BP), and cerebral blood flow velocity in extremely low gestational age neonates (ELGANs) during transition.MethodsThis study comprises secondary analyses from a prospective observational study conducted at a tertiary Neonatal Intensive Care Unit. Recruited ELGANs underwent cerebral saturation (CrSO2) monitoring and serial echocardiography during 72 h from birth. Correlative analyses of CrSO2 and cerebral fractional tissue oxygen extraction (CFTOE) with left (LVO) and right ventricular output (RVO), superior vena cava (SVC) flow, middle cerebral artery blood flow mean velocity (MCA.MV), systolic (SBP), diastolic (DBP), and mean (MBP) BP were conducted.ResultsFifty ELGANs with median (range) gestational age of 25.9 (23.1–27.9) weeks were recruited. Echocardiography was performed sequentially at a median (range) age 5.0 (3.8–6.6), 17.3 (15.4–19.4), 31.0 (27.0–34.1), and 53.7 (49.3–58.3) hours. RVO, LVO, CrSO2, and SBP increased over time but no changes in MBP, DBP, CFTOE, MCA.MV or SVC flow were noted. A weak correlation was identified between CrSO2 and SBP (r2 = 0.11, p = 0.047) and MBP (r2 = 0.12, p = 0.04) at 17.3 (15.4–19.4) hours. No correlation of either CrSO2 or CFTOE with any measures of blood flow was identified.ConclusionThere is a weak correlation between measures of cardiac output, BP, and MCA.MV with both CrSO2 and CFTOE in ELGANs during transition. Whether this finding suggests intact cerebral autoregulation requires prospective evaluation in a cohort of sick ELGANs.

cardiac output

cerebral oxygenation

extremely low gestational age

preterm

transition

Details

Title: Subtitle: Relationship between cerebral oxygenation, cardiac output, and blood pressure during transitional period in extremely low gestational age neonates
Creators: Poorva Deshpande - University of Toronto
Caio Barbosa de Olivera - Department of Pediatrics, Mount Sinai Hospital, Toronto, ON, Canada
Amish Jain - University of Toronto
Cecil Hahn - Hospital for Sick Children
Prakesh S. Shah - University of Toronto
Anne-Marie Guerguerian - Hospital for Sick Children
Patrick J. McNamara - University of Iowa
Resource Type: Journal article
Publication Details: Frontiers in pediatrics, Vol.11, 1187769
DOI: 10.3389/fped.2023.1187769
PMID: 37654688
PMCID: PMC10466030
NLM abbreviation: Front Pediatr
eISSN: 2296-2360
Publisher: Frontiers Media S.A
Language: English
Date published: 08/01/2023
Academic Unit: Stead Family Department of Pediatrics; Neonatology; Internal Medicine
Record Identifier: 9984455981602771

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