Abnormal cerebral haemodynamics in perinatally asphyxiated neonates related to outcome.
OBJECTIVE
To measure changes in cerebral haemodynamics during the first 24 hours of life following perinatal asphyxia, and relate them to outcome.


METHODS
Cerebral blood volume (CBV), its response (CBVR) to changes in arterial carbon dioxide tension (PaCO(2)), and cerebral blood flow (CBF) were measured using near infrared spectroscopy (NIRS) in 27 term newborn infants with clinical and/or biochemical evidence consistent with perinatal asphyxia.


RESULTS
Both CBF and CBV were higher on the first day of life in the infants with adverse outcomes, and a CBV outside the normal range had a sensitivity of 86% for predicting death or disability. The mean (SD) CBVR on the first day of life was 0.13 (0.12) ml/100 g/1/kPa, which, in 71% of infants, was below the lower 95% confidence limit for normal subjects.


CONCLUSIONS
An increase in CBV on the first day of life is a sensitive predictor of adverse outcome. A reduction in CBVR is almost universally seen following asphyxia, but is not significantly correlated with severity of adverse outcome.
Meek
J H
JH
Department of Paediatrics The Rayne Institute University College London Medical School London WC1E 6JJ. j.meek@ucl.ac.uk
Elwell
C E
CE
McCormick
D C
DC
Edwards
A D
AD
Townsend
J P
JP
Stewart
A L
AL
Wyatt
J S
JS
D001238:Asphyxia Neonatorum / Q000503:physiopathology*; D001810:Blood Volume / Q000502:physiology; D002245:Carbon Dioxide / Q000097:blood; D002560:Cerebrovascular Circulation / Q000502:physiology*; D005500:Follow-Up Studies; D006439:Hemodynamics / Q000502:physiology; D006801:Humans; D007231:Infant, Newborn; D010313:Partial Pressure; D011379:Prognosis; D019265:Spectroscopy, Near-Infrared
D002245:Carbon Dioxide