title: Cerebral hemodynamics and oxygenation after serial CSF drainage in infants with PHVD.
abstract: The aim of our study was to assess consecutive changes in cerebral oxygenation and hemodynamics after serial cerebrospinal fluid (CSF) drainage from a subcutaneous ventricular catheter reservoir (SVCR) in infants with PHVD. Infants with PHVD were studied during CSF drainage from a SVCR on the day of SVCR placement, half a week and one week after SVCR placement. Changes in cHbD and CBV were assessed using near infrared spectrophotometry. Time averaged peak flow velocity (TAPFV), end diastolic flow velocity (EDFV), peak systolic flow velocity (PSFV) and pulsatility index (PI) were measured before (baseline) and after CSF drainage using Doppler ultrasound. Longitudinal data analysis was performed using linear mixed models. Seven patients (GA 26.7-40.4 weeks, BW 800-4575 g) were studied. CSF drainage resulted in a statistically significant increase in CBV during each measurement. The change in CBV was maximal on the day of SVCR placement. A significant increase in cHbD and EDFV, and decrease in PI was observed after CSF drainage only on the day of SVCR placement. Baseline values of all Doppler variables improved consecutively after serial CSF removal in the first week after SVCR placement. Frequent CSF drainage results in consecutive improvement of cerebral perfusion and oxygenation in infants with PHVD.
authors.affiliation: Subdivision Neonatology, Department of Pediatrics, Radboud University, Nijmegen Medical Centre, The Netherlands. J.vanAlfen@cukz.umcn.nl
authors.forename: Adriana A E M
authors.initials: AA
authors.lastname: van Alfen-van der Velden
authors.forename: Jeroen C W
authors.initials: JC
authors.lastname: Hopman
authors.forename: John H G M
authors.initials: JH
authors.lastname: Klaessens
authors.forename: Ton
authors.initials: T
authors.lastname: Feuth
authors.forename: Rob C A
authors.initials: RC
authors.lastname: Sengers
authors.forename: Kian D
authors.initials: KD
authors.lastname: Liem
mesh_terms: D001783:Blood Flow Velocity / Q000502:physiology; D001794:Blood Pressure / Q000502:physiology; D001921:Brain / Q000098:blood supply*; D002557:Cerebrospinal Fluid Shunts; D005260:Female; D005865:Gestational Age; D006339:Heart Rate / Q000502:physiology; D006439:Hemodynamics / Q000502:physiology*; D006801:Humans; D006849:Hydrocephalus / Q000150:complications / Q000601:surgery*; D007231:Infant, Newborn; D007235:Infant, Premature, Diseases / Q000097:blood / Q000601:surgery*; D020300:Intracranial Hemorrhages / Q000150:complications / Q000601:surgery*; D008137:Longitudinal Studies; D008297:Male; D019265:Spectroscopy, Near-Infrared / Q000379:methods; D013997:Time Factors; D018608:Ultrasonography, Doppler / Q000379:methods