Hemodynamic Patterns Determined By Non-Invasive Cw-Doppler Ultrasound Cardiac Monitoring (USCOM) in Preterm Neonates with Respiratory Distress Syndrome During Non-Invasive Respiratory Support

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Abstract


Aim: to determine the hemodynamic patterns in preterm neonates with respiratory distress syndrome (RDS) by using the USCOM-1A technology.

Materials and Methods. The USCOM device is a bedside method to evaluate cardiac output (CO) basing on continuous-wave Doppler ultrasound. Hemodynamic parameters were measured daily for 7 days in 32 preterm neonates 32 ± 1 weeks of gestation (1688 ± 111 g) with RDS who required non-invasive respiratory support (NCPAP, NIPPV, HFNC) and no catecholamine support in comparison with 28 healthy term neonates (3100 ± 690 g).

Results. In day 1 preterm neonates had lower SVI (18 ± 5 vs 28 ± 8 ml m–2, p = 0.043) and higher SVRI (1585 ± 245 vs 1035 ± 358 dyn s cm–5 m2, p = 0.013) with tendency to lower cardiac index (2.6 ± 0.8 vs 4.0 ± 1.3 l min–1 m–2, p = 0.089). Together with no difference in SMII it indicates to the presence of diastolic dysfunction with low preload. It is detected that all parameters had not changed by the day 7 in preterm neonates whereas term neonates demonstrated significantly increased SMII that can reflect postnatal cardiovascular adaptation. Compared with preterm neonates with RDS who required NCPAP/NIPPV preterm neonates who required HFNC had higher levels of FTc (330 ± 59 vs 388 ± 41 ms, р = 0,045), SVI (13 ± 3 vs 18 ± 4, ml/m2, р = 0,007), SMII (0.41 ± 0.09 vs 0.57 ± 0.21, р = 0.02) and CI (2.2 ± 0.6 vs 4.5 ± 0.9 l/min/m2, р = 0.006).

Conclusions. Non-unvasive respiratory support in preterm neonates with RDS may lead to diastolic dysfunction which was less prominent in neonates with HFNC.


Vera A Sergeeva

Author for correspondence.
verasergeeva1973@icloud.com
Kursk State Medical University, Ministry of Healthcare of the Russian Federation
Russian Federation, Kursk, Russia

MD, PhD, Dr Med Sci, Professor, Department of Anesthesiology and Intensive Care Faculty of Postgraduate Education

Yuri S Alexandrovich

Jalex1963@mail.ru
St Petersburg State Pediatric Medical University, Ministry of Healthcare of the Russian Federation
Russian Federation, Saint Petersburg, Russia

MD, PhD, Dr Med Sci, Professor, Head. Department of Anesthesiology and Intensive Care and Emergency Pediatrics Faculty of Postgraduate Education

Denis M Strelkov

denistrel@yandex.ru
Kursk Regional Perinatal Centre
Russian Federation, Kursk, Russia

MD, neonatologist. Neonatology Department

Kseniya A Siniuk

siniuk@yandex.ru
Kursk State Medical University, Ministry of Healthcare of the Russian Federation
Russian Federation, Kursk, Russia

Resident, Department of Anesthesiology and Intensive Care Faculty of Postgraduate Education

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