Cerebral blood flow monitoring using a novel laser Doppler flowmeter in asphyxiated infants.
BACKGROUND
The aim of the present study was to investigate the role of early changes in cerebral blood flow (CBF) predicting the severity of neurological outcome in asphyxiated infants.


METHODS
Serial monitoring of CBF was performed using a newly developed laser Doppler flowmeter (LDF) in parallel with conventional hemodynamic monitoring, such as mean arterial blood pressure (mABP) or heart rate (HR) in 11 asphyxiated infants (five infants with neurological sequelae and six infants without sequelae) during the first 4 days of life. Psychomotor development was followed up to 20 months.


RESULTS
No differences in average CBF, mABP, average HR, or Apgar scores were found between infants with neurological sequelae and those without (P > 0.1). Significant difference was found only in average stability index during the first 48 h of life (SI48), defined as a coefficient of variation of CBF during the corresponding period (P= 0.04). An SI48 > or = 0.24 had positive predictive value of 100% for neurological sequelae while that <0.24 had a negative predictive value of 66.7%.


CONCLUSIONS
SI48, an average stability index of CBF during the first 48 h of life, can be a useful index to predict neurological outcome in asphyxiated infants.
Department of Pediatrics, Kansai Medical University, Osaka, Japan.
Atsushi
A
Ohashi
Yuichi
Y
Kuroyanagi
Naoyuki
N
Kitamura
Yo
Y
Kinoshita
Kazunari
K
Kaneko
Keijiro
K
Yabuta
D001238:Asphyxia Neonatorum / Q000150:complications*; D054022:Cerebrum / Q000098:blood supply; D004867:Equipment Design; D006801:Humans; D020925:Hypoxia-Ischemia, Brain / Q000175:diagnosis* / Q000209:etiology*; D007231:Infant, Newborn; D017078:Laser-Doppler Flowmetry / Q000295:instrumentation / Q000379:methods; D008991:Monitoring, Physiologic / Q000295:instrumentation* / Q000379:methods*; D011379:Prognosis; D011446:Prospective Studies; D012039:Regional Blood Flow