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Non-invasive measurements of ductus arteriosus flow directly after birth

机译:出生后直接进行动脉导管流动的无创测量

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Objective: To assess ductus arteriosus (DA) blood flow directly after birth in healthy term infants after elective caesarean section. Design: In healthy term newborns, echocardiography was performed at 2, 5 and 10 min after birth to monitor cardiac output and DA blood flow. Heart rate (HR) was assessed using ECG. Setting: The delivery rooms of the Leiden University Medical Center. Patients: 24 healthy term infants born after a caesarean section were included in this study. Results: Mean (SD) HR did not change (158 (18) beats per minute (bpm), 5 min (159 (23) bpm) and 10 min (156 (19) bpm). DA diameter decreased from 5.2 (1.3) mm at 2 min to 4.6 (1.3) mm at 5 min (p=0.01) to (3.9 (1.2) mm) (p=0.01) at 10 min. Right-to-left DA shunting was unaltered (median (IQR) 95 (64-154) mL/kg/min to 90 (56-168) mL/kg/min and 80 (64-120) mL/kg/min, respectively (ns)), whereas left-to-right shunting significantly increased between 2 and 5 min (41 (31-70) mL/kg/min vs 67 (37-102) mL/kg/min (p=0.01)) and increased significantly between 2 and 10 min (93 (67-125)) mL/kg/min (p<0.001). Right-to-left/left-to-right shunting ratio decreased significantly from 2.1 (1.4-3.1) at 2 min to 1.4 (1.0-1.8) at 5 min (p<0.0001) and to 0.9 (0.6-1.1) at 10 min (p<0.0001). Conclusions: DA shunting changes swiftly from predominantly right-to-left shunting to predominantly left-to-right shunting at 10 min after birth, reflecting differential changes in pulmonary and systemic vascular resistance.
机译:目的:评估选择性剖腹产后健康足月婴儿出生后的动脉导管(DA)血流量。设计:在健康足月新生儿中,在出生后第2、5和10分钟进行超声心动图检查,以监测心输出量和DA血流。使用ECG评估心率(HR)。地点:莱顿大学医学中心的产房。患者:本研究包括剖腹产后出生的24例健康足月婴儿。结果:平均(SD)心率保持不变(158(18)每分钟(bpm),5分钟(159(23)bpm)和10分钟(156(19)bpm)。DA直径从5.2(1.3)降低2分钟时的毫米至5分钟时的4.6(1.3)毫米(p = 0.01)至10分钟时的(3.9(1.2)毫米)(p = 0.01)毫米从右至左DA分流不变(中位数(IQR)95 (64-154)mL / kg / min分别达到90(56-168)mL / kg / min和80(64-120)mL / kg / min(ns)),而从左向右分流明显增加2至5分钟之间(41(31-70)mL / kg / min与67(37-102)mL / kg / min(p = 0.01))之间的关系,并在2至10分钟之间显着增加(93(67-125)) )mL / kg / min(p <0.001)。从右到左/从左到右的分流比从2分钟时的2.1(1.4-3.1)降至5分钟时的1.4(1.0-1.8)(p <结论:出生后10分钟,DA分流从主要从右向左分流迅速转变为主要从左向右分流,迅速变化为10分钟时的0.9(0.6-1.1)(p <0.0001)。在肺和全身血管抵抗中ce。

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