Low cerebral blood flow resistance in nonventilated preterm infants predicts poor neurologic outcome.
OBJECTIVE
To examine whether cerebral blood flow variables during the first critical day of life can predict the 1-yr neurologic outcome in ventilated and nonventilated preterm infants.


METHODS
Prospective follow-up study.


METHODS
Neonatal intensive care unit of university central hospital.


METHODS
Forty-nine preterm infants <33 wks of gestation.


METHODS
Doppler ultrasound investigations of the brain circulation, heart rate, and systemic blood pressure were performed in ventilated (n = 35) and nonventilated (n = 14) preterm infants during the first day of life. The neurologic development was evaluated using Griffith's subscales at 12 months of corrected age.


RESULTS
Cerebral blood flow velocity measurements were obtained from the anterior cerebral artery and internal carotid artery. Cerebral blood flow, cerebral blood flow resistance, and cerebral perfusion pressure subsequently were derived. These derived cerebral perfusion variables were associated with the sum of Griffith's developmental scales (p <.02). However, the slopes of regression lines between cerebral blood flow or cerebral blood flow resistance and the sum of Griffith's psychomotor developmental scales tended to be different in the ventilated and nonventilated infants (p =.06, p =.003, respectively). The correlations between these variables and the sum of Griffith's psychomotor developmental scales were significant only in nonventilated preterm infants (r =.69, p =.007, and r = -.85, p =.001, respectively).


CONCLUSIONS
Our data suggest that lowered cerebral blood flow resistance reflecting lowered cerebral blood flow during early circulatory transition is associated with adverse outcome in nonventilated preterm infants, but no connection in ventilated infants was found.
Ojala
Tiina
T
Research Centre of Applied and Preventive Cardiovascular Medicine, The Department of Pediatrics, University of Turku, Finland.
Kääpä
Pekka
P
Helenius
Hans
H
Ekblad
Ulla
U
Kero
Pentti
P
Välimäki
Ilkka
I
Aärimaa
Tuula
T
D001783:Blood Flow Velocity; D001921:Brain / Q000503:physiopathology; D002560:Cerebrovascular Circulation; D002657:Child Development; D005260:Female; D006801:Humans; D007231:Infant, Newborn; D007234:Infant, Premature / Q000502:physiology*; D008297:Male; D011237:Predictive Value of Tests; D011597:Psychomotor Performance; D017585:Ultrasonography, Doppler, Transcranial; D014655:Vascular Resistance