title: Skin blood flow as a predictor of intraventricular hemorrhage in very-low-birth-weight infants.
abstract: BACKGROUND
  Cardiovascular instability immediately after birth is associated with intraventricular hemorrhage (IVH) in very-low-birth-weight (VLBW) infants. For circulatory management, evaluation of organ blood flow is important. In this study, the relationship between peripheral perfusion within 48 h after birth and IVH was evaluated in VLBW infants.
  
  
  METHODS
  In this prospective observational study involving 83 VLBW infants, forehead blood flow (FBF) and lower-limb blood flow (LBF) were measured for 48 h after birth using a laser Doppler flowmeter. Blood flow was compared between infants with and without IVH. Multivariate logistic regression analysis was performed to identify the risk factors for IVH.
  
  
  RESULTS
  IVH developed in nine infants. In eight of these patients, IVH occurred after 24 h. LBF was lower in infants with IVH at 18 and 24 h and increased to the same level as that of infants without IVH at 48 h. Multivariate logistic regression analysis identified a correlation only between LBF and IVH at 18 h.
  
  
  CONCLUSIONS
  These findings were consistent with the hypoperfusion-reperfusion theory, which states that IVH develops after reperfusion subsequent to hypoperfusion. We speculate that measurement of skin blood flow in addition to systemic and cerebral circulation may be helpful in predicting IVH.
authors.affiliation: Department of Neonatal Medicine, Center for Maternal, Fetal and Neonatal Medicine, Saitama Medical Center, Saitama Medical University, Kawagoe, Saitama, Japan.
authors.forename: Akio
authors.initials: A
authors.lastname: Ishiguro
authors.affiliation: Department of Pediatrics, Tokai University School of Medicine, Isehara-shi, Japan.
authors.forename: Keiji
authors.initials: K
authors.lastname: Suzuki
authors.affiliation: Department of Pediatrics, Toho University Ohashi Medical Center, Tokyo, Japan.
authors.forename: Takashi
authors.initials: T
authors.lastname: Sekine
authors.affiliation: Department of Neonatal Medicine, Center for Maternal, Fetal and Neonatal Medicine, Saitama Medical Center, Saitama Medical University, Kawagoe, Saitama, Japan.
authors.forename: Yousuke
authors.initials: Y
authors.lastname: Sudo
authors.affiliation: Department of Neonatal Medicine, Center for Maternal, Fetal and Neonatal Medicine, Saitama Medical Center, Saitama Medical University, Kawagoe, Saitama, Japan.
authors.forename: Hidenori
authors.initials: H
authors.lastname: Kawasaki
authors.affiliation: Department of Neonatal Medicine, Center for Maternal, Fetal and Neonatal Medicine, Saitama Medical Center, Saitama Medical University, Kawagoe, Saitama, Japan.
authors.forename: Kanako
authors.initials: K
authors.lastname: Itoh
authors.affiliation: Department of Neonatal Medicine, Center for Maternal, Fetal and Neonatal Medicine, Saitama Medical Center, Saitama Medical University, Kawagoe, Saitama, Japan.
authors.forename: Masayo
authors.initials: M
authors.lastname: Kanai
authors.affiliation: Department of Neonatal Medicine, Center for Maternal, Fetal and Neonatal Medicine, Saitama Medical Center, Saitama Medical University, Kawagoe, Saitama, Japan.
authors.forename: Ineko
authors.initials: I
authors.lastname: Kato
authors.affiliation: Department of Neonatal Medicine, Center for Maternal, Fetal and Neonatal Medicine, Saitama Medical Center, Saitama Medical University, Kawagoe, Saitama, Japan.
authors.forename: Hisanori
authors.initials: H
authors.lastname: Sobajima
authors.affiliation: Department of Neonatal Medicine, Center for Maternal, Fetal and Neonatal Medicine, Saitama Medical Center, Saitama Medical University, Kawagoe, Saitama, Japan.
authors.forename: Masanori
authors.initials: M
authors.lastname: Tamura
mesh_terms: D001794:Blood Pressure; D002543:Cerebral Hemorrhage / Q000097:blood*; D005260:Female; D005546:Forehead / Q000098:blood supply; D006801:Humans; D007231:Infant, Newborn; D019102:Infant, Very Low Birth Weight; D017078:Laser-Doppler Flowmetry; D008297:Male; D015999:Multivariate Analysis; D010477:Perfusion; D011446:Prospective Studies; D012039:Regional Blood Flow; D012307:Risk Factors; D012867:Skin / Q000098:blood supply*; D013997:Time Factors; D014463:Ultrasonography