Continuous cerebral electrical impedance monitoring in sick preterm infants.
Cerebral electrical impedance (dZ) and intra-arterial blood pressure were measured continuously during the first 48 h after birth in 26 sick ventilated preterm infants with a birth weight less than 1500 g. The aim was to establish whether any patterns of dZp or the variability of either blood pressure or dZp would allow identification of those infants who developed intraventricular haemorrhage (IVH), periventricular leucomalacia (PVL) or a poor neurological outcome. IVH and PVL were diagnosed by ultrasound image obtained every 6 h. Cerebral electrical impedance recordings were unsuitable for analysis in three patients and a further three died within 14 h of birth. In the remaining 20 patients, no step changes that may have been related to the onset of IVH or PVL were evident and whilst three patterns of dZp were identified, they were not useful in distinguishing between normal infants or those who developed IVH, PVL or had a poor neurological outcome. Using multiple linear regression, the coefficient of variation of dZp was significantly associated with both IVH and outcome, as was the coefficient of variation of blood pressure. Continuous measurement of cerebral electrical impedance, whilst technically feasible in sick preterm infants, was not found useful as a method of identifying those who developed IVH, PVL or had a poor neurological outcome.
Colditz
P B
PB
Department of Paediatrics, University of Oxford, UK.
Valimaki
I A
IA
Murphy
D
D
Rolfe
P
P
Wilkinson
A R
AR
D001795:Blood Pressure Determination; D002543:Cerebral Hemorrhage / Q000175:diagnosis / Q000503:physiopathology*; D002560:Cerebrovascular Circulation; D004678:Encephalomalacia / Q000503:physiopathology*; D005260:Female; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D007235:Infant, Premature, Diseases / Q000175:diagnosis / Q000503:physiopathology*; D007969:Leukomalacia, Periventricular / Q000175:diagnosis / Q000503:physiopathology*; D008297:Male; D008991:Monitoring, Physiologic; D010992:Plethysmography, Impedance; D012044:Regression Analysis