Multimodal approach to intraventricular hemorrhage using echocardiography, near-infrared spectroscopy, and electrical cardiometry in preterm infants

OBJECTIVE: To investigate single versus combination hemodynamic parameters on intraventricular hemorrhage (IVH) or mortality in preterm infants. STUDY DESIGN: Data from 482 infants under 32 weeks gestational age were analyzed, including cerebral oximetry, mean arterial pressure (MAP), cardiac output, and systemic blood flow within the first 24 h. Wilcoxon Rank-Sum and chi-squared tests compared variables. Multivariable logistic regression and receiver operator curve (ROC) analyses assessed predictive value. RESULTS: Each additional gestational week was associated with lower odds of IVH (OR = 0.66; 95% CI: 0.57-0.75) and mortality (OR = 0.56; 95% CI: 0.45-0.69). Adjusted for covariates, right ventricular output (RVO) was associated with reduced IVH odds (AOR = 0.996; 95% CI: 0.991-0.999), and higher MAP with reduced mortality (AOR = 0.81; 95% CI: 0.68-0.94). Average NIRS < 74% in 24 h increased mortality risk (OR = 4.16; 95% CI: 1.46-11.0; P = 0.005). CONCLUSION: Select hemodynamic measures are associated with IVH and death. Combining factors did not enhance early risk prediction.