title: Changes in skin and subcutaneous perfusion in very-low-birth-weight infants during the transitional period.
abstract: BACKGROUND
  Conventional parameters of circulation that are routinely used in neonatal intensive care units, including blood pressure, have been reported to be inadequate in improving prognosis of very-low-birth-weight (VLBW) infants. Recently, the importance of evaluating the blood flow to each organ, including both vital and nonvital organs, has been increasingly recognized.
  
  
  OBJECTIVE
  To study the changes in peripheral perfusion occurring in VLBW infants of less than 32 weeks' gestation during the extrauterine transitional period.
  
  
  METHODS
  In 32 VLBW infants of less than 32 weeks' gestation, forehead blood flow (FBF) and lower-limb blood flow (LBF) were measured for 48 h after birth using a novel laser Doppler flowmeter, and the indices of vascular resistance were estimated. Superior vena cava (SVC) blood flow was measured by echocardiography. Changes in these variables of circulation as well as the correlations were evaluated.
  
  
  RESULTS
  Both FBF and LBF significantly increased at 24 h, while the SVC flow remained unchanged over the same period. Both forehead and lower-limb vascular resistance indices significantly decreased at 24 h. LBF was negatively and positively correlated with estimated upper body vascular resistance and SVC flow, respectively.
  
  
  CONCLUSIONS
  The increase in the peripheral blood flow along with the decrease in the peripheral vascular resistance indices, without an increase in the systemic blood flow at 24 h of age, indicated vasodilation in skin and subcutaneous tissue during the transitional period in VLBW infants. FBF and LBF can be useful parameters as indicators of both peripheral and systemic circulation.
authors: Division of Neonatal Medicine, Center for Maternal, Fetal and Neonatal Medicine, Saitama Medical Center, Kawagoe, Japan. akio-i@k4.dion.ne.jp
authors: Akio
authors: A
authors: Ishiguro
authors: Takashi
authors: T
authors: Sekine
authors: Keiji
authors: K
authors: Suzuki
authors: Clara
authors: C
authors: Kurishima
authors: Shoichi
authors: S
authors: Ezaki
authors: Tetsuya
authors: T
authors: Kunikata
authors: Hisanori
authors: H
authors: Sobajima
authors: Masanori
authors: M
authors: Tamura
mesh_terms: D001794:Blood Pressure / Q000502:physiology; D005260:Female; D005546:Forehead / Q000098:blood supply*; D006801:Humans; D007231:Infant, Newborn; D019102:Infant, Very Low Birth Weight / Q000502:physiology*; D007363:Intensive Care Units, Neonatal; D017078:Laser-Doppler Flowmetry; D035002:Lower Extremity / Q000098:blood supply*; D008297:Male; D012039:Regional Blood Flow / Q000502:physiology*; D012189:Retrospective Studies; D012867:Skin / Q000098:blood supply*; D013997:Time Factors; D014655:Vascular Resistance / Q000502:physiology; D014683:Vena Cava, Superior / Q000502:physiology*