Low Cardiac Output in Extremely Low Gestation Age Neonates and Intraventricular Haemorrhage

Abstract

This thesis is a commented monothematic collection of nine publications addressing cardiovascular assessment in preterm and term infants with a special focus on the immediate postnatal period. At the beginning, it provides a literature review of different modalities of Cardiac Output (CO) measurements in neonates, pathophysiology of Peri-intraventricular Haemorrhage (PIVH) in preterm infants and short review of the neonatal transition with some notes on role of the Patent Ductus Arteriosus (PDA). The main thesis is then divided into three logical parts. In the first and the main part, CO measurement possibilities in the neonatal period are reviewed and published with bioreactance identified as a novel emerging method of continuous CO assessment. The second study of this part is a prospective, observational cohort study in infants with a birth weight of less than 1250g. The CO was measured by bioreactance between 6 and 48 hours of age. Infants with PIVH and/or Necrotising Enterocolitis (NEC) had significantly lower CO compared to infants without these complications on day one of life. This low CO was then followed by a significant increase on day two of life. The third study is a prospective observational cohort study in near term and term infants undergoing Therapeutic Hypothermia (TH) for..