Continued advances in Doppler ultrasound methods have provided a noninvasive technique for analysis of blood flow velocity within the chambers of the heart, across the cardiac valves, and in a variety of vessels.'-4 Recently, these techniques have been applied successfully to insonation of the ascending aortic flow stream in newborns and infants, allowing quantification of ascending aortic blood velocity and estimation of left ventricular cardiac These noninvasive methods provide clinically useful information about overall systemic oxygen delivery, hemodynamics, and myocardial function in a variety of settings where application of invasive techniques would be problematic.This article will review our experience with pulsed-Doppler derivation of ascending aortic blood velocity and estimation of left ventricular cardiac output in newborns and infants. Clinical applications and limitations of this method are also addressed.
Instrumentation and MethodsAt our institution, ascending aortic blood velocity signals are obtained in newborns and infants using 5-or 3.5-MHz, ranged-gated, pulsed-Doppler velocimeters* and an appropriate "hammer head" suprasternal transducer or duplex-Doppler imaging probe. * Normal Q A o for neonates = 230 k 50. CV = cardioversion; bpm = beats per minute; Q A o = cardiac output.