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The aim of the study was to evaluate the relationship between superior vena cava (SVC) flow measurements within the first 24 hours of life and development of intraventricular hemorrhage in preterm born infants.
A prospective, observational cohort study was carried out on newborns that fulfill the eligibility criteria and delivered at the Alexandria University Maternity Hospital (AUMH).
The Neonatal Intensive Care Unit (NICU) of Alexandria University Maternity Hospital with total admissions of approximately 2100 newborn per year of which approximately more than 50% are admitted due to prematurity and its complications.
The study was carried out in 3 phases:
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| Measure | Description | Time Frame |
|---|---|---|
| Superior vena cava (SVC) flow | This was measured using echocardiography. SVC diameter will be visualized from a high parasternal long axis view. The maximum and minimum internal diameters will be then measured off-line from a frozen two-dimensional image showing the vessel walls at the point where SVC starts to open up into the right atrium. Mean of the maximum and minimum diameter used for the flow calculation.
SVC flow (ml/kg/min) = {VTI (cm/beat) × 3.14 × (mean SVC diameter2/4) × heart rate (beat/min) }/body weight in kg | Day 1 |
| Intraventricular hemorrhage (IVH) assessment | Cranial ultrasound will be performed after the echocardiography:
Grade I: Hemorrhage limited to germinal matrix Grade II: Blood noted within the ventricular system but not distending it Grade III: Blood in the ventricles with distension of the ventricles Grade IV: Intraventricular hemorrhage with parenchymal extension | Day 1 |
| Intraventricular hemorrhage (IVH) assessment | Cranial ultrasound will be performed after the echocardiography:
Grade I: Hemorrhage limited to germinal matrix Grade II: Blood noted within the ventricular system but not distending it Grade III: Blood in the ventricles with distension of the ventricles Grade IV: Intraventricular hemorrhage with parenchymal extension | Day 3 |
| Intraventricular hemorrhage (IVH) assessment |
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Inclusion Criteria:
Exclusion Criteria:
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Newborns with very low birth weight (≤1500 g) or ≤ 32 weeks gestation who were admitted to neonatal intensive care unit in the first day of life where evaluation of the relationship between superior vena cava (SVC) flow measurements within the first 24 hours of life and development of intraventricular hemorrhage were assessed.
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| Name | Affiliation | Role |
|---|---|---|
| Mohamed AM Khalifa, MBBCh | Faculty of Medicine, Alexandria University, Egypt | Principal Investigator |
| Mohamed H Gouda, PhD | Faculty of Medicine, Alexandria University, Egypt | Study Director |
| Ali M Abd Almohsen, PhD | Faculty of Medicine, Alexandria University, Egypt | Study Director |
| Marwa M Farag, PhD | Faculty of Medicine, Alexandria University, Egypt | Study Chair |
| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| Neonatal Intensive Care Unit (NICU) of Alexandria University Maternity Hospital. | Alexandria | 21131 | Egypt |
| PubMed Identifier | Type | Citation | Retractions |
|---|---|---|---|
| 10794783 | Background | Kluckow M, Evans N. Superior vena cava flow in newborn infants: a novel marker of systemic blood flow. Arch Dis Child Fetal Neonatal Ed. 2000 May;82(3):F182-7. doi: 10.1136/fn.82.3.f182. | |
| 305471 | Background | Papile LA, Burstein J, Burstein R, Koffler H. Incidence and evolution of subependymal and intraventricular hemorrhage: a study of infants with birth weights less than 1,500 gm. J Pediatr. 1978 Apr;92(4):529-34. doi: 10.1016/s0022-3476(78)80282-0. |
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Cranial ultrasound will be performed after the echocardiography:
Grade I: Hemorrhage limited to germinal matrix Grade II: Blood noted within the ventricular system but not distending it Grade III: Blood in the ventricles with distension of the ventricles Grade IV: Intraventricular hemorrhage with parenchymal extension |
| Day 7 |
| Anterior cerebral artery (ACA) flow velocity assessment | Transcranial Doppler (TCD) ultrasonography was used to assess the anterior cerebral artery flow velocity | Day 1 |
| 36171508 | Derived | Farag MM, Gouda MH, Almohsen AMA, Khalifa MA. Intraventricular hemorrhage prediction in premature neonates in the era of hemodynamics monitoring: a prospective cohort study. Eur J Pediatr. 2022 Dec;181(12):4067-4077. doi: 10.1007/s00431-022-04630-5. Epub 2022 Sep 28. |