Asymmetry of cerebral blood flow velocity in low birth weight infants.
BACKGROUND
In premature infants, intraventricular hemorrhage occurs more commonly in the left than the right hemisphere. We have demonstrated previously that cerebral blood flow velocity is lower in the left than the right middle cerebral artery in the first few hours after birth. This may be due to the open ductus arteriosus.


OBJECTIVE
To test the hypothesis that blood flow velocity is lower in the left than the right middle cerebral artery only when the ductus arteriosus is open.


METHODS
Infants born at 25-33 weeks' gestation were enrolled. Middle cerebral artery blood flow velocities and coefficients of variation were measured on the left, followed by the right, on days 1 and 7 of life. Echocardiography identified 67 infants (25-33 weeks, 517-2,371 g) whose ductus arteriosus was open on day 1 and closed on day 7.


RESULTS
Systolic (26.4 +/- 7.4 vs. 29.6 +/- 7.2 cm/s), mean (12.4 +/- 4.0 vs. 15.6 +/- 4.6 cm/s) and end-diastolic (5.3 +/- 2.2 vs. 6.8 +/- 2.9 cm/s) blood flow velocities were lower (p < 0.01) and the corresponding coefficients of variation were higher (p < 0.01) on the left on day 1. Neither the absolute Doppler blood flow velocities nor the coefficients of variation differed between the left and right sides on day 7.


CONCLUSIONS
Blood flow velocity is lower and more variable in the left compared to the right middle cerebral artery on day 1 of life in premature infants. These differences are not found on day 7. We speculate that this difference is due to the associated ductus arteriosus patency.
Swarup
Jyothi
J
Department of Pediatrics, University of Pittsburgh School of Medicine, Pittsburgh, Pa., USA.
Baker
Robyn Wyman
RW
Brozanski
Beverly Sobchak
BS
Yanowitz
Toby Debra
TD
D001783:Blood Flow Velocity; D002536:Cerebral Arteries / Q000000981:diagnostic imaging / Q000503:physiopathology*; D015331:Cohort Studies; D004374:Ductus Arteriosus, Patent / Q000000981:diagnostic imaging / Q000503:physiopathology*; D004452:Echocardiography; D006801:Humans; D007230:Infant, Low Birth Weight; D007231:Infant, Newborn; D018608:Ultrasonography, Doppler