title: Relationship between systemic blood flow, blood pressure, inotropes, and aEEG in the first 48 h of life in extremely preterm infants.
abstract: BACKGROUND
  Significant hemodynamic changes occur immediately after birth in preterm infants. Amplitude-integrated electroencephalography (aEEG) provides a method of assessing brain activity in sick neonates; however, the relationship among systemic blood flow, blood pressure (BP), and aEEG is not clear.
  
  
  METHODS
  Quantitative measures of aEEG continuity and amplitude were correlated with superior vena cava (SVC) flow, right-ventricular output (RVO), and BP at 12, 24, and 48 h in 92 infants born at <29 wk gestation.
  
  
  RESULTS
  SVC flow, RVO, BP, aEEG amplitude, and EEG continuity all increased from 12 to 48 h. SVC flow at 12 h, but not 24 or 48 h, was significantly associated with aEEG amplitude after adjustment for gestational age (GA) and severity of illness markers (r(2) = 0.21, P = 0.004). RVO and BP showed less consistent associations with aEEG parameters. Infants receiving inotropes at 12 h, including those in whom cardiovascular parameters had normalized, had significantly lower aEEG amplitude (P < 0.01) and EEG continuity at the 10, 25, and 50 μV levels (P < 0.01) at 12, 24, and 48 h than neonates who were not receiving inotropes.
  
  
  CONCLUSIONS
  aEEG measurements in the first 48 h of life are related to SVC flow and treatment with inotropes at 12 h of life in extremely preterm infants.
authors.affiliation: Department of Neonatology, Westmead Hospital, Westmead, Australia. dharmeshparul@yahoo.com
authors.forename: Dharmesh
authors.initials: D
authors.lastname: Shah
authors.forename: Mary
authors.initials: M
authors.lastname: Paradisis
authors.forename: Jennifer R
authors.initials: JR
authors.lastname: Bowen
mesh_terms: D000704:Analysis of Variance; D001775:Blood Circulation / Q000187:drug effects / Q000502:physiology*; D001794:Blood Pressure / Q000187:drug effects / Q000502:physiology*; D002316:Cardiotonic Agents / Q000494:pharmacology*; D004569:Electroencephalography / Q000379:methods*; D006801:Humans; D062071:Infant, Extremely Premature / Q000502:physiology*; D007231:Infant, Newborn; D009517:New South Wales; D012044:Regression Analysis; D014683:Vena Cava, Superior / Q000502:physiology; D016278:Ventricular Function, Right / Q000502:physiology
chemical_list: D002316:Cardiotonic Agents