Hemodynamics of infants with strong fluctuations of internal cerebral vein.
Blood Flow Velocity
/ physiology
Blood Pressure
/ physiology
Cerebral Veins
/ diagnostic imaging
Cerebrovascular Circulation
/ physiology
Ductus Arteriosus, Patent
/ physiopathology
Female
Humans
Infant, Extremely Low Birth Weight
Infant, Newborn
Infant, Premature
Infant, Premature, Diseases
/ diagnostic imaging
Male
Retrospective Studies
Stroke Volume
/ physiology
Ultrasonography
blood pressure
extremely low-birthweight infant
intraventricular hemorrhage
patent ductus arteriosus
ultrasonography
Journal
Pediatrics international : official journal of the Japan Pediatric Society
ISSN: 1442-200X
Titre abrégé: Pediatr Int
Pays: Australia
ID NLM: 100886002
Informations de publication
Date de publication:
May 2019
May 2019
Historique:
received:
27
04
2018
revised:
01
01
2019
accepted:
06
03
2019
pubmed:
12
3
2019
medline:
2
1
2020
entrez:
12
3
2019
Statut:
ppublish
Résumé
There is a high incidence of intraventricular hemorrhage in extremely low-birthweight (ELBW) infants of low gestational age with high-grade fluctuations in the perfusion waveform of the internal cerebral vein. This study investigated changes in the hemodynamic status of ELBW infants during initial strong fluctuations in the perfusion waveform of the internal cerebral vein. We evaluated the perfusion waveform of the internal cerebral vein in 192 ELBW infants from birth, every 8 h for a total of 120 h. Sixty-seven infants had high-grade fluctuations. On the basis of the presence of patent ductus arteriosus (PDA), patients were subdivided into PDA(-) (n = 32) and PDA(+) (n = 35) groups. During the first high-grade fluctuation, the PDA(-) group had significant increases in systolic, diastolic, and mean blood pressure (P < 0.001 for all). The PDA(+) group did not have significant changes in blood pressure but did have significant increases in the number of interruptions or regurgitations of diastolic renal arterial blood flow (P = 0.04) and end-diastolic left pulmonary arterial flow velocity (P < 0.001), indicating increased left-to-right shunt. Blood pressure elevation may underlie fluctuations in the perfusion waveform of the internal cerebral vein and lead to the first high-grade increases during acute management of ELBW infants. When no elevation in blood pressure occurred, hemodynamically significant PDA was considered a potential underlying factor.
Sections du résumé
BACKGROUND
BACKGROUND
There is a high incidence of intraventricular hemorrhage in extremely low-birthweight (ELBW) infants of low gestational age with high-grade fluctuations in the perfusion waveform of the internal cerebral vein. This study investigated changes in the hemodynamic status of ELBW infants during initial strong fluctuations in the perfusion waveform of the internal cerebral vein.
METHODS
METHODS
We evaluated the perfusion waveform of the internal cerebral vein in 192 ELBW infants from birth, every 8 h for a total of 120 h. Sixty-seven infants had high-grade fluctuations. On the basis of the presence of patent ductus arteriosus (PDA), patients were subdivided into PDA(-) (n = 32) and PDA(+) (n = 35) groups.
RESULTS
RESULTS
During the first high-grade fluctuation, the PDA(-) group had significant increases in systolic, diastolic, and mean blood pressure (P < 0.001 for all). The PDA(+) group did not have significant changes in blood pressure but did have significant increases in the number of interruptions or regurgitations of diastolic renal arterial blood flow (P = 0.04) and end-diastolic left pulmonary arterial flow velocity (P < 0.001), indicating increased left-to-right shunt.
CONCLUSIONS
CONCLUSIONS
Blood pressure elevation may underlie fluctuations in the perfusion waveform of the internal cerebral vein and lead to the first high-grade increases during acute management of ELBW infants. When no elevation in blood pressure occurred, hemodynamically significant PDA was considered a potential underlying factor.
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
475-481Informations de copyright
© 2019 Japan Pediatric Society.