Abstract :
Keywords Hemodynamics; Very-low-birth-weight infant; Extremely low-birth-weight infant; Patent ductus arteriosus; PDA ligation Highlights * Evaluating the hemodynamic changes in preterm infants following PDA ligation and assessing the factors that may influence these changes * The hemodynamic changes measured by USCOMs are similar to those measured by echocardiography in previous reports * The postoperative course after PDA ligation may be modifiable, with hemodynamic monitoring by a USCOM guiding the use of fluid, inotropic agents, and vasopressors Abstract Background Cardiorespiratory instability occurs very often in very-low-birth-weight (VLBW) and extremely-low-birth-weight (ELBW) infants undergoing patent ductus arteriosus (PDA) ligation during the early postoperative period. This study aimed to investigate ultrasonic cardiac output monitor (USCOM) as a bedside tool by evaluating the hemodynamic changes in preterm infants following PDA ligation and assessing factors that may influence these changes. Methods This was a single-center prospective observational study at a third-level neonatal intensive care unit. A total of 33 infants, including 21 VLBW and 12 ELBW infants, were involved. Hemodynamic measurements were performed in these infants using a USCOM preoperatively as well as 0--1 h, 8--10 h, and 24 h postoperatively. Results The PDA ligation was associated with reductions of the left ventricular cardiac output (LVCO) (P Conclusion Our study confirmed that the hemodynamic changes measured by the USCOM were similar to those measured by echocardiography in previous reports. Thus, USCOM is a useful and convenient bedside tool for assessing hemodynamic changes to guide the use of fluids, inotropic agents, and vasopressors and help modify the post-ligation course, and they may be a surrogate for repeated echocardiography during the early post-ligation period in preterm infants or a preliminary screening method. Author Affiliation: (a) The Second School of Clinical Medicine, Southern Medical University, Guangzhou 510280, China (b) Department of Neonatology, Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences, Guangzhou 510080, China (c) Department of Neonatology, Senior Department of Pediatrics, the Seventh Medical Center of PLA General Hospital, Beijing 100853, China * Corresponding author at: Department of Neonatology, Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences, Guangzhou 510080, The Second School of Clinical Medicine, Southern Medical University, No. 253 of Industrial Avenue, Haizhu District, Guangzhou 510280, China. Article History: Received 4 August 2021; Revised 15 November 2021; Accepted 1 December 2021 Byline: Yu-Mei Liu (a,b), Man-Li Zheng (b), Xin Sun (b), Xiao-Bo Chen (b), Yun-Xia Sun (b), Zhi-Chun Feng (c), Shao-Ru He [shaoruhe7@126.com] (b,a,*)