Neonatal Hemodynamics: From Developmental Physiology to Comprehensive Monitoring

Overview

Journal Front Pediatr

Specialty Pediatrics

Date 2018 Apr 21

PMID 29675404

Citations 40

Authors

Sabine L Vrancken

Arno F Van Heijst

Willem P de Boode

Affiliations

Soon will be listed here.

Abstract

Maintenance of neonatal circulatory homeostasis is a real challenge, due to the complex physiology during postnatal transition and the inherent immaturity of the cardiovascular system and other relevant organs. It is known that abnormal cardiovascular function during the neonatal period is associated with increased risk of severe morbidity and mortality. Understanding the functional and structural characteristics of the neonatal circulation is, therefore, essential, as therapeutic hemodynamic interventions should be based on the assumed underlying (patho)physiology. The clinical assessment of systemic blood flow (SBF) by indirect parameters, such as blood pressure, capillary refill time, heart rate, urine output, and central-peripheral temperature difference is inaccurate. As blood pressure is no surrogate for SBF, information on cardiac output and systemic vascular resistance should be obtained in combination with an evaluation of end organ perfusion. Accurate and reliable hemodynamic monitoring systems are required to detect inadequate tissue perfusion and oxygenation at an early stage before this result in irreversible damage. Also, the hemodynamic response to the initiated treatment should be re-evaluated regularly as changes in cardiovascular function can occur quickly. New insights in the understanding of neonatal cardiovascular physiology are reviewed and several methods for current and future neonatal hemodynamic monitoring are discussed.

Citing Articles

Intelligent Neonatal Blood Perfusion Assessment System Based on Near-Infrared Spectroscopy.

Chen H, Lin B, Chang C, Chung H, Yang S, Lin B IEEE J Transl Eng Health Med. 2025; 13:23-32.

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Enteral Nutrition in Neonates on Inotropic Support Admitted to a Tertiary Neonatal Intensive Care Unit: A Prospective Cohort Study.

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Cerebral fractional tissue oxygen extraction (cFTOE) during immediate fetal-to-neonatal transition: a systematic qualitative review of the literature.

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