Document Detail

Cerebral autoregulation of preterm neonates--a non-linear control system?
MedLine Citation:
PMID:  8198408     Owner:  NLM     Status:  MEDLINE    
The low frequency cerebral blood flow velocity (CBFV) oscillations in neonates are commonly attributed to an under-dampened immature linear type cerebral autoregulation, and the 'instability' is regarded as causative for peri-intraventricular haemorrhage/periventricular leukomalacia. In contrast, oscillations susceptible to frequency entrainment are a fundamental part of the stable function of non-linear control systems. To classify the autoregulation an observational study was done on the relationship between CBFV oscillations, heart rate variability, and artificial ventilation. In 10 preterm neonates (gestational age 26 to 35 weeks) we serially Doppler traced arterial CBFV continuously for 12 minutes between days 1 and 49 of life. The individual time series of CBFV and heart rate were subjected to spectral analysis. Forty six of 47 tracings showed significant low frequency CBFV oscillations. Low frequency heart rate oscillations were not a prerequisite thereof. All patients with < 30% of total power in the low frequency band of CBFV oscillations were on the ventilator. Three of them demonstrated a shift of spectral power from low frequency to a frequency equal or harmonic to the ventilator rate indicating entrainment. The findings of CBFV oscillations combined with entrainment classify the autoregulation as a non-linear system. It is suggested that entrainment by periodic high amplitude stimuli might challenge the regulatory capacity to its limits thus increasing the risk for cerebral damage.
B Zernikow; E Michel; G Kohlmann; J Steck; R M Schmitt; G Jorch
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Publication Detail:
Type:  Journal Article; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  Archives of disease in childhood. Fetal and neonatal edition     Volume:  70     ISSN:  1359-2998     ISO Abbreviation:  Arch. Dis. Child. Fetal Neonatal Ed.     Publication Date:  1994 May 
Date Detail:
Created Date:  1994-06-29     Completed Date:  1994-06-29     Revised Date:  2009-11-18    
Medline Journal Info:
Nlm Unique ID:  9501297     Medline TA:  Arch Dis Child Fetal Neonatal Ed     Country:  ENGLAND    
Other Details:
Languages:  eng     Pagination:  F166-73     Citation Subset:  AIM; IM    
University Children's Hospital, Muenster, Germany.
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MeSH Terms
Blood Flow Velocity / physiology
Carotid Artery, Internal / ultrasonography
Cerebral Hemorrhage / physiopathology
Cerebrovascular Circulation / physiology*
Heart Rate / physiology
Homeostasis / physiology
Infant, Newborn
Infant, Premature / physiology*
Leukomalacia, Periventricular / physiopathology
Longitudinal Studies
Respiration, Artificial / adverse effects
Comment In:
Arch Dis Child. 1994 Sep;71(2):F150   [PMID:  7979480 ]

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine

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