Nick J Evans

Learn More
BACKGROUND Ventricular outputs cannot be used to assess systemic blood flow in preterm infants because they are confounded by shunts through the ductus arteriosus and atrial septum. However, flow measurements in the superior vena cava (SVC) can assess blood returning from the upper body and brain. OBJECTIVES To describe a Doppler echocardiographic(More)
One hundred and twenty ventilated preterm infants, birthweight < 1500 g, were examined within the first 36 hours with colour Doppler echocardiography, to determine the cardiorespiratory influences on right (RVO) and left ventricular output (LVO). Forty nine of these infants had three further daily scans. Measurements included left ventricular (LV) ejection(More)
OBJECTIVE Our purpose was to determine if dobutamine or dopamine results in greater improvements in systemic blood flow in very preterm infants with low flow during the first 24 hours of life. STUDY DESIGN A 2-center, randomized, double-blind study. Infants (n = 42) with low superior vena cava (SVC) flow (<41 mL/kg/min) in the first 12 hours were randomly(More)
AIM To establish if there is an association between early cardiovascular adaptation and intraventricular haemorrhage (IVH). METHODS One hundred and seventeen ventilated preterm infants (mean gestational age 27 weeks, mean birthweight 993 g) were studied echocardiographically within the first 36 hours. Measurements included right (RVO) and left ventricular(More)
OBJECTIVE The goal was to report the 1- and 3-year outcomes of preterm infants with low systemic blood flow in the first day and the effect of dobutamine versus dopamine for treatment of low systemic blood flow. METHODS A cohort of 128 infants born at <30 weeks of gestation underwent echocardiographic measurement of superior vena cava flow at 3, 10, and(More)
Much epidemiological evidence has linked low birthweight with late cardiovascular risk. We measured aortic wall thickness (a marker of early atherosclerosis) by ultrasonography in 25 newborn babies with intrauterine growth restriction and 25 with normal birthweight. Maximum aortic thicknesses were significantly higher in the babies with intrauterine growth(More)
AIMS To examine the hypothesis that right to left shunting occurs mainly in the lungs rather than through the fetal channels in neonates. METHODS Thirty two term babies requiring over 70% oxygen had daily colour Doppler echocardiograms until recovery. Measurements included left ventricular fractional shortening, right and left ventricular outputs, colour(More)
OBJECTIVE To determine if indomethacin given to preterm infants with a large ductus arteriosus (DA) in the first hours of life results in maintained or improved brain and upper body blood (superior vena cava (SVC)) flow. STUDY DESIGN A randomised, double blind trial of indomethacin v placebo. Echocardiography was performed on 111 infants born at < 30(More)
OBJECTIVES To document the incidence, timing, degree, and associations of systemic hypoperfusion in the preterm infant and to explore the temporal relation between low systemic blood flow and the development of intraventricular haemorrhage (IVH). STUDY DESIGN 126 babies born before 30 weeks' gestation (mean 27 weeks, mean body weight 991 g) were studied(More)
OBJECTIVE To assess the effectiveness of early prophylactic milrinone versus placebo for prevention of low systemic blood flow in high-risk preterm infants. STUDY DESIGN Double-blind randomized placebo controlled trial of milrinone (loading dose 0.75 microg/kg/min for 3 hours then maintenance 0.2 microg/kg/min until 18 hours after birth) versus placebo.(More)