Eric S Peeples1, Edin Mehic2, Pierre D Mourad2,3, Sandra E Juul1. 1. Department of Pediatrics, University of Washington, Seattle, Washington. 2. Department of Neurological Surgery, University of Washington, Seattle, Washington. 3. Division of Engineering and Mathematics, University of Washington, Seattle, Washington.
Abstract
BACKGROUND: Altered cerebral perfusion from impaired autoregulation may contribute to the morbidity and mortality associated with premature birth. We hypothesized that fast Doppler imaging could provide a reproducible bedside estimation of cerebral perfusion and autoregulation in preterm infants. METHODS: This is a prospective pilot study using fast Doppler ultrasound to assess blood flow velocity in the basal ganglia of 19 subjects born at 26-32 wk gestation. Intraclass correlation provided a measure of test-retest reliability, and linear regression of cerebral blood flow velocity and heart rate or blood pressure allowed for estimations of autoregulatory ability. RESULTS: The intraclass correlation when imaging in the first 48 h of life was 0.634. We found significant and independent correlations between the systolic blood flow velocity and both systolic blood pressure and heart rate (P = 0.015 and 0.012 respectively) only in the 26-28 wk gestational age infants in the first 48 h of life. CONCLUSION: Our results suggest that fast Doppler provides reliable bedside measurements of cerebral blood flow velocity at the tissue level in premature infants, acting as a proxy for cerebral tissue perfusion. Additionally, autoregulation appears to be impaired in the extremely preterm infants, even within a normal range of blood pressures.
BACKGROUND: Altered cerebral perfusion from impaired autoregulation may contribute to the morbidity and mortality associated with premature birth. We hypothesized that fast Doppler imaging could provide a reproducible bedside estimation of cerebral perfusion and autoregulation in preterm infants. METHODS: This is a prospective pilot study using fast Doppler ultrasound to assess blood flow velocity in the basal ganglia of 19 subjects born at 26-32 wk gestation. Intraclass correlation provided a measure of test-retest reliability, and linear regression of cerebral blood flow velocity and heart rate or blood pressure allowed for estimations of autoregulatory ability. RESULTS: The intraclass correlation when imaging in the first 48 h of life was 0.634. We found significant and independent correlations between the systolic blood flow velocity and both systolic blood pressure and heart rate (P = 0.015 and 0.012 respectively) only in the 26-28 wk gestational age infants in the first 48 h of life. CONCLUSION: Our results suggest that fast Doppler provides reliable bedside measurements of cerebral blood flow velocity at the tissue level in premature infants, acting as a proxy for cerebral tissue perfusion. Additionally, autoregulation appears to be impaired in the extremely preterm infants, even within a normal range of blood pressures.
Authors: Regina A Gargus; Betty R Vohr; Jon E Tyson; Pamela High; Rosemary D Higgins; Lisa A Wrage; Kenneth Poole Journal: Pediatrics Date: 2009-07 Impact factor: 7.124
Authors: Janet S Soul; Peter E Hammer; Miles Tsuji; J Philip Saul; Haim Bassan; Catherine Limperopoulos; Donald N Disalvo; Marianne Moore; Patricia Akins; Steven Ringer; Joseph J Volpe; Felicia Trachtenberg; Adré J du Plessis Journal: Pediatr Res Date: 2007-04 Impact factor: 3.756
Authors: Simon Hyttel-Sorensen; Adelina Pellicer; Thomas Alderliesten; Topun Austin; Frank van Bel; Manon Benders; Olivier Claris; Eugene Dempsey; Axel R Franz; Monica Fumagalli; Christian Gluud; Berit Grevstad; Cornelia Hagmann; Petra Lemmers; Wim van Oeveren; Gerhard Pichler; Anne Mette Plomgaard; Joan Riera; Laura Sanchez; Per Winkel; Martin Wolf; Gorm Greisen Journal: BMJ Date: 2015-01-05
Authors: Yvonne A Eiby; Nicole Y Shrimpton; Ian M R Wright; Eugenie R Lumbers; Paul B Colditz; Greg J Duncombe; Barbara E Lingwood Journal: Pediatr Res Date: 2016-08-04 Impact factor: 3.756