PEDIATRICS Vol. 76 No. 6 December 1985, pp. 918-921
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Cardiac Output Changes in Newborns With Hyperbilirubinemia Treated With Phototherapy

Frans J. Walther MD, PhD1, Paul Y. K. Wu MD1, and Bijan Siassi MD1

1 From the Neonatalogy Division, Department of Pediatrics, University of Southern California School of Medicine, Los Angeles County-USC Medical Center, Los Angeles, and the University of Limburg, Maastricht, The Netherlands

Phototherapy is known to increase peripheral blood flow in neonates, but information on the associated cardiovascular effects is not available. Using pulsed Doppler echocardiography we evaluated cardiac output and stroke volume in 12 preterm and 13 term neonates during and after phototherapy. We concomitantly measured arterial limb blood flow by strain gauge plethysmography and skin blood flow by photoplethysmography. Cardiac output decreased by 6% due to reduced stroke volume during phototherapy, whereas total limb blood flow and skin blood flow increased by 38% and 41%, respectively. Peripheral blood flow increments tended to be higher in the preterm than in the term infants. The reduced stroke volume during phototherapy may be an expression of reduced activity of the newborn during phototherapy. For healthy neonates the reduction in cardiac output is minimal, but for sick infants with reduced cardiac output, this reduction may further aggravate the decrease in tissue perfusion.

Key Words: cardiac output • blood flow • phototherapy • echocardiography • plethysmography

Submitted on November 20, 1984
Accepted on March 27, 1985