Circulatory effects of ventilator rate and end-expiratory pressure in unparalysed preterm infants.
Impairment of cerebrovascular autoregulation may be important in the pathogenesis of ischaemic brain injury in preterm infants. A previous study in ventilated preterm infants paralysed with pancuronium showed that changes in cerebral blood flow velocity (CBFV) were related to concomitant changes in arterial blood pressure. In a similar study in unparalysed infants, changes in CBFV in response to changes in ventilator rate or end-expiratory pressure were independent of associated changes in the arterial blood pressure. These results emphasize the importance of avoiding large swings in blood pressure in paralysed infants. Whether alternative paralysing agents have similar effects warrants further study.
Bohin
S
S
Department of Child Health, Leicester University Medical School, Leicester Royal Infirmary, UK.
Fenton
A C
AC
Thompson
J R
JR
Evans
D H
DH
Field
D J
DJ
D001794:Blood Pressure; D001921:Brain / Q000098:blood supply* / Q000503:physiopathology; D002545:Brain Ischemia / Q000209:etiology / Q000503:physiopathology; D005865:Gestational Age; D006706:Homeostasis; D006801:Humans; D007231:Infant, Newborn; D007234:Infant, Premature; D008448:Maximal Expiratory Flow Rate; D012121:Respiration, Artificial; D012127:Respiratory Distress Syndrome, Newborn / Q000628:therapy*