title: Difference in cerebral blood flow velocity in neonates with and without hyperbilirubinemia.
abstract: OBJECTIVE
  To evaluate the difference in cerebral blood flow velocity (CBFV) in neonates with and without hyperbilirubinemia.
  
  
  METHODS
  CBFV of 70 healthy late-preterm and term newborns with unconjugated hyperbilirubinemia (UCH) reaching the threshold of phototherapy requirement was compared with 70 gestational- and postnatal age-matched controls without hyperbilirubinemia. Resistance index (RI), pulsatility index (PI), peak systolic velocity (PSV) and vascular diameter were measured in internal carotid, vertebral and middle cerebral arteries by transcranial color Doppler ultrasound at the beginning of phototherapy, after 48-72h of starting phototherapy and at 5-7days after its stoppage. In controls CBFV was assessed once at inclusion.
  
  
  RESULTS
  Both the groups were comparable. An increase in CBFV (decreased RI and PI, increased PSV and vasodilation) was observed in the UCH group. A further increase in CBFV was noticed after 48h of phototherapy. After 5-7days of stoppage of phototherapy, though there was a significant reduction in CBFV in mild-to-moderate UCH (serum bilirubin ⩽25mg/dL), in severe UCH (serum bilirubin >25mg/dL), CBFV remained increased. Four neonates developed features of acute bilirubin encephalopathy and had significantly higher CBFV compared to those with normal outcome.
  
  
  CONCLUSIONS
  An increase in CBFV was observed in neonates with UCH compared to those without hyperbilirubinemia.
authors.affiliation: Department of Pediatrics, Institute of Medical Sciences, Banaras Hindu University, Varanasi 221005, India. Electronic address: drsriparnabasu@rediffmail.com.
authors.forename: Sriparna
authors.initials: S
authors.lastname: Basu
authors.affiliation: Department of Pediatrics, Institute of Medical Sciences, Banaras Hindu University, Varanasi 221005, India.
authors.forename: Dibyajyoti
authors.initials: D
authors.lastname: De
authors.affiliation: Department of Radiodiagnosis, Institute of Medical Sciences, Banaras Hindu University, Varanasi 221005, India.
authors.forename: Ram Chandra
authors.initials: RC
authors.lastname: Shukla
authors.affiliation: Department of Pediatrics, Institute of Medical Sciences, Banaras Hindu University, Varanasi 221005, India.
authors.forename: Ashok
authors.initials: A
authors.lastname: Kumar
mesh_terms: D001783:Blood Flow Velocity; D002343:Carotid Artery, Internal / Q000000981:diagnostic imaging / Q000502:physiology; D016022:Case-Control Studies; D002536:Cerebral Arteries / Q000000981:diagnostic imaging / Q000502:physiology; D002560:Cerebrovascular Circulation / Q000502:physiology*; D005260:Female; D005865:Gestational Age; D006801:Humans; D006932:Hyperbilirubinemia / Q000503:physiopathology*; D007231:Infant, Newborn; D007234:Infant, Premature; D008297:Male; D008517:Phytotherapy; D018615:Ultrasonography, Doppler, Color; D014655:Vascular Resistance; D014711:Vertebral Artery / Q000000981:diagnostic imaging / Q000502:physiology
keywords: Cerebral blood flow velocity; Neonate; Phototherapy; Transcranial color Doppler ultrasound; Unconjugated hyperbilirubinemia