ABSTRACT
Objective To investigate the roles of cardiac activity index(Tei index) on evaluation the right ventricular function after neonatal asphyxia.Methods Sixty neonatal asphyxia who included 35 cases of mild asphyxia(mild asphyxia group) and 25 cases of severe asphyxia(severe asphyxia group) and 30 cases of normal full-term newborns(control group) were selected.Echocardiographic examinations were performed on 24-48 h after birth,which included pulmonary artery systolic pressure (PASP),right ventricular ejection fraction(RVEF),tricuspid early diastolic peak(peak E) and late diastolic peak(peak A),and E/A ratio was acquired.The right ventricular cardiac activity index (RV-Tei index) was measured by Doppler spectrum.Results There was no significant difference in RVEF,E/A ratio among mild asphyxia group,severe asphyxia group and control group (P ＞ 0.05).RV-Tei index in mild asphyxia group and severe asphyxia group was increased compared with that in control group (0.489 ± 0.090,0.625 ± 0.100 vs.0.345 ± 0.120),and there was significant difference (P＜ 0.05 or ＜0.01).There was significant difference in RV-Tei index between mild asphyxia group and severe asphyxia group (P ＜ 0.05).RV-Tei index in neonatal asphyxia was positively correlated with PASP (r =0.950,P ＜ 0.05),and there was no relationship between RV-Tei index and gestational age,weight,heart rate (r =-0.068,-0.280,-0.360,P ＞0.05).Conclusions Neonatal asphyxia can lead to disorders of the right ventricular function.Tei index can evaluate early overall changes of the right ventricular function and is better than conventional ultrasound technology in neonatal asphyxia.
ABSTRACT
ObjectiveTo explore the clinical value of respiratory mechanics in neonates with neonatal respiratory distress syndrome (NRDS).MethodsAccording to prognosis,55 newborns with NRDS who had been treated with pulmonary surfactant in our hospital from Jan 2006 to Dec 2008 were divided into 2 groups:44 newborns in survival group and 11 newborns in death group.The dynamical changes of compliance of the respiratory system (Crs),respiratory index (RI) and PA-a O2 were measured during mechanical ventilation.ResultsAt 6 h after mechanic ventilation,there were significant differences in Crs,PA-a O2,OI and RI between the survival group and the death group (t=6.871,-6.450,-10.316,-8.815,P＜0.05 ).In the survival group,RI,PA-aO2 and OI decreased with the time of ventilation,and there were significant differences among the different time point ( F=215.56,147.85,384.64,P＜0.05).In thesurvival group,Crs increased with the time of ventilation,and there were significant differences among the different time point ( F=292,P＜0.05).In the death group,RI,PA-aO2 and OI increased respectively just before dying than at 6 h after mechanic ventilation (t=-5.699,-5.578,-6.924,P＜0.05 ).In the death group,Crs decreased respectively just before dying than at 6 h after mechanic ventilation (t=11.767,P＜0.05 ).Crs was negative correlated with OI,RI and PA-aO2 (r=-0.813,-0.800,-0.859,P＜0.05 ).ConclusionMonitoring in NRDS children's dynamic changes of Crs,RI,OI,PA-a O2 can help observing effect of treatment,guiding ventilator treatment,grasping the opportunity and assessing the prognosis offline in NRDS.