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Superior vena cava flow and intraventricular haemorrhage in extremely preterm infants

Sarah Bates1, David Odd1,2, Karen Luyt2

  • 1a Neonatal Intensive Care Unit , Southmead Hospital, North Bristol NHS Trust , Bristol , UK , and.

The Journal of Maternal-Fetal & Neonatal Medicine : the Official Journal of the European Association of Perinatal Medicine, the Federation of Asia and Oceania Perinatal Societies, the International Society of Perinatal Obstetricians
|June 27, 2015
PubMed

Insights

Early superior vena cava flow (SVCF) in extremely preterm infants correlates with ductal shunting. However, SVCF measurements within 24 hours of birth are not a reliable predictor for developing intraventricular haemorrhage (IVH).

Area of Science:

  • Neonatal physiology
  • Pediatric cardiology
  • Neonatal neurology

Background:

  • Intraventricular haemorrhage (IVH) is a significant complication in extremely preterm infants.
  • Early physiological markers may help predict IVH development.
  • Superior vena cava flow (SVCF) is a potential indicator of circulatory status in neonates.

Purpose of the Study:

  • To investigate the association between early superior vena cava flow (SVCF) measurements and the incidence of intraventricular haemorrhage (IVH).
  • To determine if SVCF can serve as a predictive marker for IVH in extremely preterm infants.

Main Methods:

  • Retrospective cohort study including 108 infants born before 28 weeks' gestation.
  • SVCF was measured within the first 24 hours of life.
  • The primary outcome was the degree of IVH assessed at 7 days postnatal age.

Main Results:

  • Infants who developed IVH had a lower mean SVCF (75 ml/kg/min) compared to those without IVH (87.7 ml/kg/min, p=0.055).
  • SVCF showed an inverse association with patent ductus arteriosus diameter and reversal of flow in the descending aorta.
  • Sensitivity analysis did not confirm an independent association between SVCF and IVH development (OR 0.990, p=0.115).

Conclusions:

  • Early SVCF in extremely preterm infants is linked to the degree of ductal shunting.
  • SVCF measurements in the first 24 hours are insensitive for predicting IVH in this population.
Abstract

Keywords:
Cardiac imaging techniquescolour Doppler echocardiographyextremely preterm infantintraventricular haemorrhagesuperior vena cava flow

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