19 Late Cord-Clamping Improves Circulation in Neonates

• Published in: Archives of disease in childhood 2012-10, Vol.97 (Suppl 2), p.A6-A6
• Main Authors: Nelle, M, Walter, KN, Gerull, R
• Format: Article
• Language: English
• Subjects: Blood pressure; Body Weight; Infants; Neonates; Young Children
• ISSN: 0003-9888; 1468-2044
• DOI: 10.1136/archdischild-2012-302724.0019

Aim was to investigate the effects of late vs. early cord clamping on systemic circulation cerebral blood flow velocity (CBFV) in prematures infants < 1500g in a randomized trial. Subjects 35 neonates were studied 4 hours after caesarean section. In 19 neonates (birth weight: 1140±240g; gestational age: 29.0±2 wks) the umbilical cords were clamped after 30 seconds and the infants were placed 30 cm below placenta level (LCC), and in 16 (1180±270g; 28.6±2 wks) the cords were clamped immediately (ECC). Methods MBP (mmHg), left ventricular output (LVO, ml/kg/min), mean cerebral blood flow velocity (CBFV) in the Arteria carotis interna (ACI, m/s; Doppler), hemoglobin (Hb, g/dl), and hematocrit (Hct, %) were measured. Systemic and cerebral hemoglobin transport (HbT), systemic vascular resistance (SVR; mmHg/kg/min-1) were estimated. Statistic: *unpaared t-test. Abstract 19 Table 1 Results ECC LCC p-value MBP 34±3 45±7 0.03 LVO 229±44 258±36 ns ACA 0.15±0.03 0.21±0.05 ns SVR 123±40 145±30 0.05 Hct 0.44±0.4 0.56±0.5 0.002 cerebral HbT 7.4±1.8 11.1±4.1 0.04 systemic HbT 154±27 181±24 0.05 Conclusions Late cord clamping improves blood pressure, systemic vascular resistance, hemoglobin, systemic and cerebral hemoglobin transport. The ECC group required more volume expansion in the first 24 h (ECC: 12/16, 14±7ml/kg; LCC: 6/19, 5±4ml/kg; p