Cerebral blood-flow velocities in predicting outcome of asphyxiated newborn infants.
OBJECTIVE
To evaluate the role of early (up to 12 h) changes in cerebral blood-flow (CBF) velocity in predicting the severity of hypoxic-ischaemic encephalopathy (HIE) and long-term outcome in asphyxiated term infants.


METHODS
CBF velocities were investigated by colour Doppler ultrasonography in 81 healthy and 60 asphyxiated term infants at least three times during the first 5 d of life. The psychomotor development of infants was followed up to 18 mo.


RESULTS
No differences in CBF velocities were found at the age of 2-6 h between infants with severe and mild-moderate HIE, mean CBF velocity [mean (95% CI of mean CBF velocity)] in anterior cerebral artery [14.9 (1.4-28.4)cm/s] and [13.9 (11.1-16.7) cm/s], respectively, and between infants with poor outcome (death or severe disability) and with normal development/mild impairments. By the age of 12 h infants with mild-moderate HIE and infants with normal development/mild impairments had decreased CBF velocity in the anterior cerebral artery, and infants with severe HIE or poor outcome had increased mean CBF velocity in anterior, medial cerebral and basilar artery compared to the control group.


CONCLUSIONS
The value of CBF velocity changes to predict poor outcome in asphyxiated infants is low 2-6 h after asphyxia, but increases by the age of 12 ho.
Ilves
P
P
Radiology Department, Tartu University Clinics, Tartu, Estonia. pilvi.ilves@kliinikum.ee
Lintrop
M
M
Metsvaht
T
T
Vaher
U
U
Talvik
T
T
D001034:Apgar Score; D001238:Asphyxia Neonatorum / Q000000981:diagnostic imaging / Q000503:physiopathology*; D001783:Blood Flow Velocity; D016022:Case-Control Studies; D002536:Cerebral Arteries / Q000000981:diagnostic imaging / Q000503:physiopathology*; D002560:Cerebrovascular Circulation; D005260:Female; D005865:Gestational Age; D006801:Humans; D007231:Infant, Newborn; D008297:Male; D017063:Outcome Assessment, Health Care; D011237:Predictive Value of Tests; D011379:Prognosis; D011446:Prospective Studies; D012016:Reference Values; D012680:Sensitivity and Specificity; D018615:Ultrasonography, Doppler, Color