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The Pathophysiology of Low Systemic Blood Flow in the Preterm Infant

Martin Kluckow1

  • 1Department of Neonatology, Royal North Shore Hospital, University of Sydney, Sydney, NSW, Australia.

Frontiers in Pediatrics
|March 6, 2018
PubMed

Insights

Understanding transitional circulation in very low birth weight (VLBW) infants is key for cardiovascular care. Ultrasound aids in assessing cardiac function and vascular resistance, enabling precise treatment and potentially reducing interventions.

Area of Science:

  • Neonatal Physiology
  • Cardiovascular Medicine
  • Pediatric Cardiology

Background:

  • Cardiovascular impairment in very low birth weight (VLBW) infants presents complex transitional physiology.
  • Systemic blood pressure, pulmonary pressures, myocardial function, and ductal shunting dynamically change postnatally.
  • Recent trials on umbilical cord clamping offer new insights into transitional circulation.

Purpose of the Study:

  • To emphasize the importance of understanding transitional cardiovascular physiology in VLBW infants.
  • To highlight the utility of ultrasound in assessing transitional hemodynamics.
  • To demonstrate how physiological assessment can guide treatment decisions.

Main Methods:

  • Review of recent clinical trials on umbilical cord clamping timing.
  • Analysis of basic science reports on transitional circulation physiology.
  • Discussion of ultrasound's role in evaluating ductus arteriosus, myocardial function, cardiac output, and vascular resistance.

Main Results:

  • Transitional circulation is a dynamic period requiring careful physiological assessment.
  • Umbilical cord clamping practices influence transitional hemodynamics.
  • Ultrasound provides critical data on cardiac function and vascular status.

Conclusions:

  • Accurate assessment of transitional physiology in VLBW infants is crucial for cardiovascular management.
  • Ultrasound assessment offers detailed physiological information, guiding targeted treatments.
  • Informed assessment can lead to more specific interventions and potentially reduce the need for treatment.

Keywords:
hemodynamicshypotensionneonatepretermsuperior vena cava

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