Study On The Dynamic Change And Correlation Of The Cardiac And Pulmonary Function In The Neonates

Objective:To investigate the dynamic change and correlation of the cardiac and pulmonary function in the neonates.Methods:(1)352 newborns were enrolled in this study,included 152 premature infants and 200 term infants.The infants were assigned intoâ… ,â…¡andâ…¢groups by gestational age which was 32w～,34w～,37w～41⁺⁶w respectively.The term and premature infants were respectively divided into A,B,C and D subgroups by age which was 0h～,24h～,72h～and 1w～28d respectively.(2)The lung ventilative and mechanical function were measured respectively by using techniques of tidal breathing flow-volume loop(TBFVL) and the single occlusion.The Master screen Paed-lung function devices of Germanic JAEGER Co.was be used in this study. The parameters of lung function included the time taken to achieve peak tidal expiratory flow as a proportion of total expiratory time(TPTEF/TE),the volume achieved peak expiratory flow as a proportion of total expiratory volume(VPEF/VE),time to peak tidal expiratory flow(TPTEF), volume to peak expiratory flow(VPEF),minute ventilation(MV),tidal volume(VT),tidal volume/kilogram(VT/kg),mean inspiratory flow(MIF),mean expiratory flow(MEF),peak expiratory flow(PEF),tidal expiratory flow 75%remaining tidal volume(TEF75),tidal expiratory flow 50%remaining tidal volume(TEF50),tidal expiratory flow 25%remaining tidal volume(TEF25),ratio of PTEF to TEF25(PTEF/TEF25),compliance of the respiratory system(Crs),resistence of the respiratory system(Rrs) and inspiratory time(Ti).The cardiac function were measured by using SonoSite 180 PLUS color Doppler ultrasonic diagonstic apparatus,the frequency of probe was 3.5MHz-5.0MHz.The parameters of cardiac function included peak flow rate of aorta valve orifice(AV),peak flow rate of pulmonary artery valve orifice(PV),cardiac output(CO),stroke volume(SV),the ratio of early(E) and late(A) diastolic velocities of tricuspid valves(TVE/A),heart rate(HR).(3)The parameters of cardiac and pulmonary function were compared among the groups and subgroups,and correlation analysis was carried on.The influential factors of cardiac and pulmonary function were carried on the multi-factor analysis.Results:(1) There were statistical significance among the groupâ… ,â…¡andâ…¢in TPTEF/TE, VPEF/VE,TPTEE MV,VT,VT/kg,MIF,MEF,PEF,TEF25,Crs,Rrs(P＜0.05).(2) There were statistical significance among groups of different age in the term and preterm infants in TPTEF/TE,VPEF/VE,TPTEF.The TPTEF/TE,VPEF/VE and TPTEF were all decreased gradually with increasing of the age.MV,VT,VT/kg,MIF,MEF,PEF,TEF75,PTEF/TEF25 were all gradually increased tendency with increasing of the age in term infants,there were all statistical significance(P＜0.05).The VT/kg and PTEF/TEF25 were all increased gradually with increasing of the age in preterm infants,there were statistical significance(P＜0.05).(3) The AV, PV,CO and SV were all increased with increasing of the gestational age among the groupâ… ,â…¡andâ…¢,there were all statistical significance(P＜0.05).(4) The PV,CO,HR were all increased with increasing of the age in preterm and term infants,there were all statistical significance(P＜0.05).(5) The effect of gestational age,age and birth weight on the cardiac and pulmonary function was most obvious during neonatal stage by multifactor analysis.(6) There were positive correlation in CO,SV,AV,PV respectively with VPEF,MV,VT,PEF,MIF,MEF, TEF75,TEF50,TEF25(P＜0.05).There were negative correlation in the TVE/A,PV respectively with TPTEF/TE,VPEF/VE,TPTEF,Ti(P＜0.01).Conclusion:(1) The compliance of the respiratory system is increased and the resistance of respiratory system decreased,the lung ventilative function is mature gradually with increasing of gestational age and age in the neonatal stage.The change of lung function is significant within the first 72h in term and premature infants,that is becoming more stable from 72h to 1 week after birth.(2) The cardiac pump and diastolic performance has not been obviously improved for postnatal 1w in the preterm infants,but enhancement remarkably in the term infants.The PV is significant augmentation within postnatal 72h in the preterm and term infants.(3) The gestational age,age and birth weight are important influencial factors of cardiac and pulmonary function in neonate.(4) It is correlated closely between the cardiac function and the lung capacity,flow rate and respiratory system resistance.