Assessment of neonatal perfusion

Gupta, Samir; Donn, Steven M.

doi:10.1016/j.siny.2020.101144

Cited by 14 publications

(9 citation statements)

References 39 publications

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“…Clinical and laboratory parameters used to assess the neonatal hemodynamics provide crude indirect indicators of systemic blood flow. They were reported to be inaccurate, irrespective of the level of experience of the clinicians [1,2].…”

Section: Introductionmentioning

confidence: 99%

Comparison of Cardiac Output Measurement by Electrical Velocimetry with Echocardiography in Extremely Low Birth Weight Neonates

2021

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Introduction: Electrical velocimetry (EV) offers a noninvasive tool for continuous cardiac output (CO) measurements which might facilitate hemodynamic monitoring and targeted therapy in low birth neonates, in whom other methods of CO measurement are not practicably feasible. Methods: This prospective observational study compared simultaneous cardiac output measurements by electrical velocimetry (COEV) with transthoracic echocardiography (COTTE) in extremely low birth weight (ELBW) neonates in the neonatal intensive care unit (NICU). Echocardiography was performed by 1 single examiner. Data were analyzed by Bland-Altman analysis and independent-samples analysis of variance. A mean percentage error (MPE) of <30% and limits of agreement (LOA) up to ±30% were considered clinically acceptable. Results: Thirty-eight ELBW neonates were studied and yielded 85 pairs of COEV and COTTE measurements. Bland-Altman analysis showed an overall bias (the mean difference) and LOA of −126 and −305 to +52 mL min−1, respectively, and an MPE of 66%. Patients with patent ductus arteriosus had a higher bias with LOA and MPE of −166.8, −370.7 to +37 mL min−1, and 69%, respectively. The overall true precision was 58%. Conclusion: This study showed high bias and lack of agreement between EV and TTE for measurement of CO in ELBW infants in NICU, limiting applicability of EV to monitor absolute values.

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Section: Introductionmentioning

confidence: 99%

Comparison of Cardiac Output Measurement by Electrical Velocimetry with Echocardiography in Extremely Low Birth Weight Neonates

2021

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“…Clinical monitoring. Routine hemodynamic monitoring of the micropreemie relies on markers of end organ perfusion, such as coreperipheral temperature differences, capillary refill time, base excess, blood lactate levels, and urine output [5]. These, however, have poor correlation with superior vena caval flow and cardiac output, with poor sensitivity and positive predictive value for the early diagnosis of shock and circulatory compromise.…”

Section: Hemodynamic Monitoring and Assessmentmentioning

confidence: 99%

Hemodynamic management of the micropreemie: When inotropes are not enough

Gupta

Donn

2022

Seminars in Fetal and Neonatal Medicine

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“…Here, laser Doppler flowmetry can provide the blood flow estimation by measuring the doppler frequency shift resulting from the reflected laser light changes in moving blood cells [7], but it is extremely sensitive to movement artifacts [8]. Based on the differences in the magnetic resonance signal between different human tissue components, the MRI technique can be used to noninvasively assess the hemodynamic changes elicited by blood flow and oxygenation during the hyperemic response, and has been developed in the applications of cerebral blood flow, ventricular function and systemic perfusion in neonates [9]. But the sedation or general anesthesia are commonly required to ensure immobilization during imaging, and this may increase the risk of adverse events, especially for neonates with complex congenital heart disease (CHD) [10].…”

Section: Introductionmentioning

confidence: 99%

An Intelligent Systemic Circulation Monitoring System for Neonatal Illness Severe Severity Evaluation

Chen,

Lin,

Chen

et al. 2023

IEEE Access

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Illness severity is a major determinant of neonatal mortality. In neonatal intensive care, severity-of-illness scales, primarily relied on subjective judgment by experienced physicians, are used to assess the mortality risk prediction and therapeutic intensity. Because cardiovascular morbidity and other disease state may contribute to hemodynamic abnormalities, the illness severity may reflect on the state of hemodynamic abnormalities. Several diagnostic approaches, such as laser Doppler flowmetry and orthogonal polarization spectral, have been developed to evaluate the local information of blood flow or vascular distribution on skin surface, but they may not efficiently evaluate the systemic circulation. In this study, an intelligent systemic circulation monitoring system was proposed to non-invasively evaluate the blood perfusion state and further estimate the illness severity. In the proposed system, a wireless sensing device was designed to real-time monitor the changes of hemoglobin parameters under the altered external pressure, and several indexes were defined from the hemodynamic response to present the blood perfusion state. The relationship between the blood perfusion state and the illness severity was also investigated in this study. Moreover, the technique of neural network was also applied in the classification of illness severity. The experimental results indicate the differences between many defined blood perfusion indexes in neonates with different illness severity were exactly significant and the mild and severe illness severity group could also be efficiently recognized by the neural network technique. Therefore, the proposed system may contain the potential of future clinical applications in the evaluation of illness severity or other diseases.

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Assessment of neonatal perfusion

Cited by 14 publications

References 39 publications

Comparison of Cardiac Output Measurement by Electrical Velocimetry with Echocardiography in Extremely Low Birth Weight Neonates

Comparison of Cardiac Output Measurement by Electrical Velocimetry with Echocardiography in Extremely Low Birth Weight Neonates

Hemodynamic management of the micropreemie: When inotropes are not enough

An Intelligent Systemic Circulation Monitoring System for Neonatal Illness Severe Severity Evaluation

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