Early cardiac and cerebral hemodynamics with umbilical cord milking compared with delayed cord clamping in infants born preterm

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dc.contributor.authorKatheria, Anup C.en
dc.contributor.authorSzychowski, Jeff M.en
dc.contributor.authorEssers, Jochenen
dc.contributor.authorMendler, Marc R.en
dc.contributor.authorDempsey, Eugene M.en
dc.contributor.authorSchmölzer, Georg M.en
dc.contributor.authorArnell, Kathyen
dc.contributor.authorRich, Wade D.en
dc.contributor.authorHassen, Kasimen
dc.contributor.authorAllman, Phillipen
dc.contributor.authorVarner, Michaelen
dc.contributor.authorCutter, Gary R.en
dc.contributor.authorFiner, Neilen
dc.date.accessioned2024-05-16T12:15:50Z
dc.date.available2024-05-16T12:15:50Z
dc.date.issued2020-07-22en
dc.description.abstractObjective: To evaluate changes in cerebral oxygenation, peripheral arterial oxygenation, respiratory status, and administered fraction of inspired oxygen during the first 10 minutes of life in premature infants receiving umbilical cord milking compared with delayed cord clamping (DCC). Study design: Premature infants born at 230/7 to 276/7 weeks of gestation were randomized to umbilical cord milking or DCC. A near infrared spectroscopy sensor, pulse oximeter, and electrocardiogram electrodes were placed. Pulse rate, cerebral tissue oxygenation, peripheral oxygen saturation, airway pressure, and fraction of inspired oxygen were collected for 10 minutes in the delivery room. Longitudinal models were used to compare effects of umbilical cord milking and DCC. Results: Fifty-six infants had cerebral oximetry and advanced monitoring at birth. There was an increased incidence of severe intraventricular hemorrhage in infants who received umbilical cord milking compared with DCC (P = .0211). Longitudinal models suggested that peripheral oxygen saturation was higher in the umbilical cord milking group in the first 4 minutes (P = .0221) and that mean airway pressures were lower in the umbilical cord milking group after the first 7 minutes (P = .0072). No statistical differences were observed for fraction of inspired oxygen, cerebral tissue oxygenation, or heart rates. Conclusions: The data suggest that the rapid transfer of blood during umbilical cord milking may facilitate lung expansion with improved pulmonary blood flow, but may also increase cerebral blood flow, resulting in severe intraventricular hemorrhage.en
dc.description.statusPeer revieweden
dc.description.versionAccepted Versionen
dc.format.mimetypeapplication/pdfen
dc.identifier.citationKatheria, A. C., Szychowski, J. M., Essers, J., Mendler, M. R., Dempsey, E. M., Schmölzer, G. M., Arnell, K., Rich, W. D., Hassen, K., Allman, P. and Varner, M. (2020) 'Early cardiac and cerebral hemodynamics with umbilical cord milking compared with delayed cord clamping in infants born preterm', Journal of Pediatrics, 223, pp. 51-56. https://doi.org/10.1016/j.jpeds.2020.04.010en
dc.identifier.doihttps://doi.org/10.1016/j.jpeds.2020.04.010en
dc.identifier.endpage56en
dc.identifier.issn0022-3476en
dc.identifier.journaltitleJournal of Pediatricsen
dc.identifier.startpage51en
dc.identifier.urihttps://hdl.handle.net/10468/15873
dc.identifier.volume223en
dc.language.isoenen
dc.publisherElsevier Inc.en
dc.rights© 2020, Elsevier Inc. All rights reserved. This manuscript version is made available under the CC BY-NC-ND 4.0 license.en
dc.rights.urihttps://creativecommons.org/licenses/by-nc-nd/4.0/en
dc.subjectCerebral oxygenationen
dc.subjectPeripheral arterial oxygenationen
dc.subjectRespiratory statusen
dc.subjectPremature infantsen
dc.subjectUmbilical cord milkingen
dc.subjectDelayed cord clamping (DCC)en
dc.titleEarly cardiac and cerebral hemodynamics with umbilical cord milking compared with delayed cord clamping in infants born pretermen
dc.typeArticle (peer-reviewed)en
oaire.citation.volume223en
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