Measuring cardiac changes using electrical impedance during delayed cord clamping: a feasibility trial.
Measuring cardiac changes using electrical impedance during delayed cord clamping: a feasibility trial.
复制标题
DOI：
10.1186/s40748-015-0016-3
复制
发表时间：
2015
期刊：
影响因子：
--
通讯作者：
Finer NN
中科院分区：
文献类型：
--
作者：
Katheria AC;Wozniak M;Harari D;Arnell K;Petruzzelli D;Finer NN
迄今为止，还没有研究试图连续评估人类延迟脊髓钳夹期间血流动力学的变化。我们的目标是演示1。延迟性脊髓夹闭时血流动力学测定的可行性;来描述每分钟发生的变化。阴道分娩后，将足月婴儿（370-416周）置于胎盘下方10-20 cm的Life Start®床上。将经皮传感器放置在颈部和胸部，以确定每次心跳时的心率、每搏输出量和心输出量。一旦获得信号，将前5个值（每次搏动）取平均值，并计算每例受试者相对于基线的百分比变化。入组了20名婴儿，所有婴儿都从经皮传感器获得了可靠的信号，并且脐带夹紧延迟约5分钟。心输出量从生命的2分钟增加到5分钟（p = 0.008）。在生命的每一分钟，脐带保持未夹紧，每搏输出量从基线增加13.1% ± 12.3（p = 0.0001），心输出量从基线增加12.6% ± 6.3（p < 0.0001）。虽然大多数婴儿在出生后5分钟时心输出量继续增加，但7/20名婴儿在出生后188 ± 41秒时达到峰值心输出量。这项研究表明，血流动力学的措施，可以成功地获得在出生后的前五分钟，而新生儿接受延迟脐带夹紧。本研究还为足月婴儿延迟脐带钳夹期间心输出量和每搏输出量的变化提供了参考值。临床Trials.gov NCT 02195037 2014年7月17日注册
To date no study has attempted to continuously evaluate changes in hemodynamics during delayed cord clamping in humans. We aimed to demonstrate 1. the feasibility of measurements of hemodynamics during delayed cord clamping and 2. to describe the changes that occur over each minute. After vaginal delivery, term infants (370-416 weeks) were placed on a Life Start® bed 10–20 cm below the placenta. Transcutaneous sensors were placed on the neck and chest to determine heart rate, stroke volume and cardiac output at each beat. Once a signal was obtained, first 5 values (taken every beat) were averaged and the percent change for each subject from baseline was calculated. 20 infants were enrolled and all had a reliable signal obtained from transcutaneous sensors and had a delay in cord clamping for about 5 minutes. Cardiac output increased from 2 to 5 minutes of life (p = 0.008). For every minute of life the cord was kept unclamped, the stroke volume increased 13.1% ± 12.3 (p = 0.0001) and cardiac output increased 12.6% ± 6.3 from baseline (p < 0.0001). While the majority of infants continued to have an increase in cardiac output at 5 minutes of life, 7/20 infants reached their peak cardiac output at 188 ± 41 seconds of life. This study demonstrates that hemodynamic measures could be successfully obtained during the first five minutes of birth and while a newborn was receiving delayed cord clamping. This study also provides reference values for changes in cardiac output and stroke volume in well term infants during delayed cord clamping. Clinical Trials.gov NCT02195037 Registered 17 July 2014