TO FIND OUT CORRELATION BETWEEN SVC FLOW AND LEFT VENTRICULAR OUTPUT IN NEWBORN BETWEEN GESTATIONAL AGE OF 34-37 WEEKS AND >37 WEEKS ON LIFE DAY ONE

Abstract

Background: Preterm newborn is vulnerable to brain injury which is thought to be caused partly by abnormalities in cerebral perfusion ⁽¹⁾. Commonly used parameters such as blood pressure & blood lactate level are not sufficient to detect low circulatory blood flow in preterm neonate  because these are poor surrogate markers of systemic blood flow during the circulatory transition just after birth Methods- The Present Prospective Cross sectional observational study was conducted in the department of Paediatrics, attached to DR.SN Medical College Jodhpur over the duration of one year .Ethical consent was taken from local institutional ethical committee of Dr.S.N Medical College Jodhpur.

Results: In present study 2D Echocardiography was done in preterm newborn  (Median  gestational age 35 week) (range 34-37 week ) on life day one for measurement of superior vena cava blood flow in which mean flow was 62.5±20.93 ml/kg/min (Mean±SD) and Median flow was  57.83ml/kg/min  and  range of SVC flow was  18-143 ml/kg/min. Also measured left ventricular output on life day one  in which Mean±SD and median LVO  flow was 204.88±70.74  and 189.5 which show r value 0.56 with significant positive predictive value <0.0001 by Pearson’s correlation  coefficient. In term newborn between gestational ages of 37-41 week with Median gestational age 39 week (range 37-41 week) on life day one. In which mean LVO flow was 203.31± 61.88 (Mean±SD)   and mean SVC flow was 58.89±19.11, (Mean±SD) Shows r value 0.40 and positive predictive value < 0.002 by using Pearson’s correlation coefficient.

Conclusion: We conclude that SVC flow measurent through 2D colour Doppler echocardiography is most reliable and non-invasive method in preterm newborn as well as evaluation of treatment. . Although echocardiographic assessment of LVO appears to be relatively robust, it is of limited clinical value preterm neonates   in the   neonatal unit setting because the majority of sick preterm neonate will have patent ductus arteriosus, meaning that LVO does not represent systemic blood flow and is in fact a better marker of pulmonary flow volume.

Keywords: SVC, Preterm, Term neonates.