PEDIATRICS Vol. 76 No. 5 November 1985, pp. 829-833
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Pulsed Doppler Determinations of Cardiac Output in Neonates: Normal Standards for Clinical Use

Frans J. Walther MD, PhD1, Bijan Siassi MD1, Naglaa A. Ramadan MD1, Ananda K. Ananda MD1, and Paul Y. K. Wu MD1

1 From the Neonatology Division, Department of Pediatrics, University of Southern California School of Medicine, Los Angeles County-USC Medical Center, Los Angeles

Noninvasive monitoring of cardiac output can greatly facilitate the clinical assessment and management of neonates with cardiovascular compromise. To assess normal values of cardiac output in neonates, mean blood flow velocity was measured in the ascending aorta from a suprasternal approach using a range-gated, pulsed Doppler velocity meter, and aortic root diameter was determined from an M-mode echocardiogram. These techniques were combined, and cardiac output was evaluated in 59 healthy premature and 62 term newborn infants during the first week of life. Birth weights ranged from 780 g to 4,740 g and gestational age from 27 to 42 weeks. Cardiac output values increased linearly with advancing birth weight (r = +.94, P < .001) and gestational age (r = +.95, P < .001). Mean cardiac output values (±SD) per kilogram of body weight were 249 ± 34 mL/mm/kg and decreased with advancing birth weight: <1,500 g = 265 ± 32 mL/min/kg; 1,500 to 2,500 g = 253 ± 34 mL/min/kg; and >2,500 g = 241 ± 33 mL/min/kg. For clinical use, 325 mL/min/kg and 200 mL/min/kg can be used as upper and lower limits of normal, respectively. Doppler cardiac output estimates compared favorably with studies using invasive techniques.

Key Words: cardiac output • neonate • pulsed Doppler technique • echocardiography

Submitted on July 30, 1984
Accepted on December 13, 1984




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