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Superior vena cava flow - feasibility and reliability of the off-line analyses.
  1. Anja Lee1,*,
  2. Knut Liestøl2,
  3. Eirik Nestaas3,
  4. Leif Brunvand1,
  5. Rolf Lindemann1,
  6. Drude Fugelseth4
  1. 1 Department of Paediatrics, Oslo University Hospital, Ulleval, Norway;
  2. 2 Department of Informatics, University of Oslo, Norway;
  3. 3 Department of Paediatrics, Vestfold Hospital Trust, Tønsberg, Norway;
  4. 4 Faculty of Medicine, University of Oslo, Norway
  1. Correspondence to: Anja Lee, Paediatrics, Oslo University Hospital Ulleval, Oslo University Hospital Ulleval, Department of Paediatrics, Oslo, 0407, Norway; anjalee{at}online.no

Abstract

Background: Superior vena cava (SVC) flow has become a surrogate measure of systemic blood flow in neonates.

Objective: The aim of this study was to establish normal SVC flow values in healthy term infants the first three days of life and to evaluate the feasibility and reliability of the off-line analyses.

Design: Doppler echocardiography of SVC flow was performed in 48 healthy term infants the first three days of life. Off-line analyses were thereafter performed by one cardiologist to investigate the changes in SVC flow from day one to three and to establish normal values. Intra- and interobserver variability was analysed in a subset of 20 infants by three paediatric cardiologists.

Results: We found a decrease in mean SVC flow from 99 ml/kg/min at day one to 77 ml/kg/min at day three. Reliable diameter images were obtained in 85%, and velocity recordings in 81%. The mean variability of SVC flow was 17% in the intraobserver analysis and 29% in the interobserver analysis.

Conclusion: The main challenge of the method is the measurement of SVC diameter.

The same observer should ideally perform sequential analyses. Special caution should be taken when making clinical implications from non-optimal pictures.

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