Noninvasive Cardiac Output Monitoring in Newborn with Hypoplastic Left Heart Syndrome

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OBJECTIVE: This study aimed to describe the first two cases of electrical cardiometry applied to newborn with hypoplastic left heart syndrome for hemodynamical assessment in the first days of life before surgical correction and see if this can help decision making process in these patients.

STUDY DESIGN: We describe two case series of two full-term newborn with hypoplastic left heart syndrome in the Neonatal Intensive Care Unit, ASST Grande Ospedale Metropolitano Niguarda, between December 2019 and January 2020.

RESULTS: Case 1 was persistently hemodynamically stable with prostaglandin E1 infusion at 0.01 mcg/kg/min, showing good capillary refill time, good diuresis, no difference between pre- and postductal values of oxygen saturation or blood pressure. Electrical cardiometry monitoring constantly showed cardiac output values higher than 300 mL/kg/min. Case 2 showed poor clinical condition needing prostaglandin E1 infusion up to 0.05 mcg/kg/min, intubation and septostomy associated with low cardiac output around 190 mL/kg/min. Once cardiac output has begun to rise and reached values constantly over 300 mL/kg/min, clinical condition improved with amelioration in oxygen saturation, diuresis, blood pressure, and blood gas analysis values. She was then extubated and finally clinically stable until surgery with minimal infusion of prostaglandin E1 at 0.01 mcg/kg/min.

CONCLUSION: This case highlights how hemodynamic information provided by electrical cardiometry can be used to supplement the combined data from all monitors and the clinical situation to guide therapy in these newborns waiting surgery.

KEY POINTS: · This is the first report of electrical cardiometry (EC) use in newborn with hypoplastic left heart syndrome (HLHS).. · In HLHS patients, it is impossible to measure cardiac output without being invasive.. · EC helps in guiding therapy in HLHS patients in a noninvasive way.

Medienart:

E-Artikel

Erscheinungsjahr:

2020

Erschienen:

2020

Enthalten in:

Zur Gesamtaufnahme - volume:37

Enthalten in:

American journal of perinatology - 37(2020), S 02 vom: 04. Sept., Seite S54-S56

Sprache:

Englisch

Beteiligte Personen:

Gatelli, Italo Francesco [VerfasserIn]
Vitelli, Ottavio [VerfasserIn]
Chiesa, Gaia [VerfasserIn]
De Rienzo, Francesca [VerfasserIn]
Martinelli, Stefano [VerfasserIn]

Links:

Volltext

Themen:

Case Reports
Journal Article

Anmerkungen:

Date Completed 16.08.2021

Date Revised 16.08.2021

published: Print-Electronic

Citation Status MEDLINE

doi:

10.1055/s-0040-1713603

funding:

Förderinstitution / Projekttitel:

PPN (Katalog-ID):

NLM314715401