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J Perinatol. 2019 May;39(5):619-625. doi: 10.1038/s41372-019-0337-6. Epub 2019 Feb 15.

The Relationship between blood pressure parameters and left ventricular output in neonates.

Author information

1
Department of Paediatrics, University of Toronto, Toronto, ON, Canada.
2
Neonatology Department, Hospital Infantil de México Federico Gómez, National Institute of Health, Mexico City, Mexico.
3
Newborn and Developmental Paediatrics, Sunnybrook Health Sciences Centre, Toronto, ON, Canada.
4
Division of Neonatology, The Hospital for Sick Children, Toronto, ON, Canada.
5
Department of Pediatrics, Icahn School of Medicine at Mount Sinai, New York, NY, USA.
6
MiCare Research Center, Mount Sinai Hospital, Toronto, ON, Canada.
7
Department of Paediatrics and Lunenfeld-Tanenbaum Research Institute, Mount Sinai Hospital, Toronto, ON, Canada.
8
Department of Paediatrics, University of Toronto, Toronto, ON, Canada. amish.jain@sinaihealthsystem.ca.
9
Department of Paediatrics and Lunenfeld-Tanenbaum Research Institute, Mount Sinai Hospital, Toronto, ON, Canada. amish.jain@sinaihealthsystem.ca.

Abstract

OBJECTIVE:

To evaluate the relationship between systolic (SBP), diastolic (DBP), mean (MBP) blood pressures and pulse pressure (PP), and left ventricular output (LVO), a surrogate of systemic blood flow.

STUDY DESIGN:

This retrospective study included neonates who underwent targeted neonatal echocardiography (TNE) in 3-tertiary NICUs over 2 years. Associations between LVO and BP components were investigated. Analysis was adjusted for relevant covariates.

RESULT:

1060 studies from 485 neonates were included, with a mean GA of 28.4 ± 4.6 weeks and birth weight of 1234 ± 840 grams. LVO was associated positively with SBP and PP, and negatively with GA. PP demonstrated the highest predictive value for identifying infants with LVO < 150 ml/kg/min (area under the curve 0.75 [95% CI 0.68, 0.82]). MBP and DBP demonstrated no correlation with LVO.

CONCLUSION:

BP parameters correlate poorly with LVO, irrespective of GA and underlying etiology. Narrow PP may be more reflective of low LVO than low SBP.

PMID:
30770881
DOI:
10.1038/s41372-019-0337-6

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