title: Changes in cerebral perfusion in extremely LBW infants during the first 72 h after birth.
abstract: Cerebral perfusion and its relation with systemic circulation in extremely LBW (ELBW) infants in the early neonatal period are not well understood. The cerebral tissue oxygenation index (TOI) and cerebral fractional tissue oxygen extraction (FTOE) were monitored in stable 16 ELBW infants (GA <29 wk) using near-infrared spectroscopy (NIRS) at 3-6, 12, 18, 24, 36, 48, and 72 h after birth. The left ventricular end-systolic wall stress (ESWS), left ventricular ejection fraction (LVEF), left ventricular cardiac output (LVCO), and superior vena cava (SVC) flow were also measured simultaneously using echocardiography. The ESWS increased till 18 h and then decreased; LVEF, LVCO, and SVC flow decreased till 12 h and increased thereafter. The TOI decreased till 12 h and correlated with SVC flow; FTOE increased until 12 h and then decreased. These changes in variables of NIRS and echocardiographic measurements contrasted to changes in mean arterial blood pressure (MABP), which showed trends of continuous and gradual increase after birth. We conclude that even stable ELBW infants undergo evident transitional changes in cerebral oxygenation and perfusion in the early postnatal period, which may reflect changes in cardiac function and cardiac output.
authors.affiliation: Department of Pediatrics, Tokyo Medical University, 6-7-1 Nishishinjuku, Shinjuku-ku, Tokyo 160-0023, Japan. takami@tokyo-med.ac.jp
authors.forename: Takeshi
authors.initials: T
authors.lastname: Takami
authors.forename: Daisuke
authors.initials: D
authors.lastname: Sunohara
authors.forename: Atsushi
authors.initials: A
authors.lastname: Kondo
authors.forename: Norio
authors.initials: N
authors.lastname: Mizukaki
authors.forename: Yuusuke
authors.initials: Y
authors.lastname: Suganami
authors.forename: Yukito
authors.initials: Y
authors.lastname: Takei
authors.forename: Tasuku
authors.initials: T
authors.lastname: Miyajima
authors.forename: Akinori
authors.initials: A
authors.lastname: Hoshika
mesh_terms: D002560:Cerebrovascular Circulation / Q000502:physiology*; D004452:Echocardiography; D005260:Female; D005865:Gestational Age; D006801:Humans; D052577:Infant, Extremely Low Birth Weight / Q000502:physiology*; D007231:Infant, Newborn; D008297:Male; D010100:Oxygen / Q000097:blood; D010101:Oxygen Consumption / Q000502:physiology; D012039:Regional Blood Flow / Q000502:physiology*; D019265:Spectroscopy, Near-Infrared / Q000379:methods
chemical_list: D010100:Oxygen