| Relationship between blood pressure, cerebral electrical activity, cerebral fractional oxygen extraction, and peripheral blood flow in very low birth weight newborn infants. | |
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MedLine Citation:
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PMID: 16439599 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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There is uncertainty about the level of systemic blood pressure required to maintain adequate cerebral oxygen delivery and organ integrity. This prospective, observational study on 35 very low birth weight infants aimed to determine the mean blood pressure (MBP) below which cerebral electrical activity, peripheral blood flow (PBF), and cerebral fractional oxygen extraction (CFOE) are abnormal. Digital EEG, recorded every day on the first 4 d after birth, were analyzed a) by automatic spectral analysis, b) by manual measurement of interburst interval, and c) qualitatively. CFOE and PBF measurements were performed using near-infrared spectroscopy and venous occlusion. MBP was measured using arterial catheters. The median (range) of MBP recorded was 32 mm Hg (16-46). The EEG became abnormal at MBP levels below 23 mm Hg: a) the relative power of the delta (0.5-3.5 Hz) frequency band was decreased, b) interburst intervals were prolonged, and c) all four qualitatively abnormal EEG (low amplitude and prolonged interburst intervals) from four different patients were recorded below this MBP level. The only abnormally high CFOE was measured at MBP of 20 mm Hg. PBF decreased at MBP levels between 23 and 33 mm Hg. None of the infants in this study developed cystic periventricular leukomalacia. One infant (MBP, 22 mm Hg) developed ventricular dilatation after intraventricular hemorrhage. The EEG and CFOE remained normal at MBP levels above 23 mm Hg. It would appear that cerebral perfusion is probably maintained at MBP levels above 23 mm Hg. |
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Authors:
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Suresh Victor; Anthony G Marson; Richard E Appleton; Margaret Beirne; A Michael Weindling |
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Publication Detail:
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Type: Journal Article; Research Support, Non-U.S. Gov't |
Journal Detail:
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Title: Pediatric research Volume: 59 ISSN: 0031-3998 ISO Abbreviation: Pediatr. Res. Publication Date: 2006 Feb |
Date Detail:
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Created Date: 2006-01-27 Completed Date: 2006-05-18 Revised Date: 2006-11-15 |
Medline Journal Info:
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Nlm Unique ID: 0100714 Medline TA: Pediatr Res Country: United States |
Other Details:
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Languages: eng Pagination: 314-9 Citation Subset: IM |
Affiliation:
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Division of Child Health, University of Liverpool, Liverpool Women's Hospital, Neonatal Unit, UK. svictor@liverpool.ac.uk |
Export Citation:
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| MeSH Terms | |
Descriptor/Qualifier:
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Blood Pressure* Brain / physiology* Cerebrovascular Circulation* Electroencephalography Fourier Analysis Humans Infant, Newborn Infant, Very Low Birth Weight / physiology* Oxygen / metabolism* |
| Chemical | |
Reg. No./Substance:
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7782-44-7/Oxygen |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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