Experimental nociceptive stimulation of the fetus and neonate induces pulmonary artery vasoconstriction. The investigators assessed whether echocardiography for Ductus arteriosus screening may generate this hemodynamic response and whether postural support would be able to modulate it. Study design Prospective, single center, randomized study in less than 29 weeks of gestation neonates, with a post natal age \< 48 hours, and requiring invasive mechanical ventilation. Crossover design with order of echocardiographies determined by computer randomization: in one group ultrasounds are performed with postural support, than standard conditions, in the other, ultrasounds are performed in standard conditions than with postural support. The objective of the study is to assess the ratio of the acceleration time/ejection time of pulmonary arterial flow. The others objectives are to assess echocardiographic-Doppler features (ductus arteriosus shunt pattern, pulmonary flow pattern, estimated systolic pulmonary arterial pressure, right and left ventricular functions using tissue Doppler imaging and speckle-tracking echocardiography), pain assessment with a clinical scale and heart rate variability analysis.
Study Type
INTERVENTIONAL
Allocation
RANDOMIZED
Purpose
PREVENTION
Masking
NONE
Enrollment
30
University hospital of Montpellier
Montpellier, France
value of the ratio of the acceleration time of pulmonary arterial flow.
for each echocardiography (support condition and postural support)
Time frame: up to 1 hour
value of the ejection time of pulmonary arterial flow
for each echocardiography (support condition and postural support)
Time frame: up to 1 hour
pain assessment with a clinical scale
assessment of the pain with a practical behavioral observation scale
Time frame: up to 1 hour
number of participant with a Patent ductus arteriosus shunt
Time frame: up to 2 hours
systolic pulmonary arterial pressure
Time frame: up to 2 hour
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