title: Changes in the perfusion waveform of the internal cerebral vein and intraventricular hemorrhage in the acute management of extremely low-birth-weight infants.
abstract: This prospective observational study aimed to investigate the association between changes in the Doppler perfusion waveform of the internal cerebral vein and risk of intraventricular hemorrhage (IVH) in extremely low-birth-weight (ELBW) infants. We evaluated the perfusion waveform of the internal cerebral vein every 8 h from immediately after birth to 144 h post-birth in 80 ELBW infants (<1,000 g) in our hospital. Fluctuations in the measured perfusion waveform were categorized into four patterns according to their increasing magnitude, from grade 0 (steady flow waveform) to grade 3; the IVH rate was investigated. Infants with grades 0-1 fluctuations of the perfusion waveform were classified as low grade (n = 55), and those with grades 2-3 fluctuations were classified as high grade (n = 25). The IVH rate was significantly higher in the high-grade group than the low-grade group (28 vs. 1%, p < 0.001). The IVH group (n = 8) showed a significantly greater rate of high-grade perfusion waveform than the non-IVH group (n = 72) (87 vs. 25%, p < 0.001).
  
  
  CONCLUSIONS
  Changes in the perfusion waveform of the internal cerebral vein during the acute management of ELBW infants may be associated with IVH.
authors.affiliation: Department of Neonatology, Perinatal Center of Aomori Prefectural Central Hospital, 2-1-1, Higashitsukurimichi, Aomori-shi, Aomori, 030-8553, Japan, ikecyobb@ybb.ne.jp.
authors.forename: Toshifumi
authors.initials: T
authors.lastname: Ikeda
authors.forename: Takasuke
authors.initials: T
authors.lastname: Amizuka
authors.forename: Yuya
authors.initials: Y
authors.lastname: Ito
authors.forename: Ryosuke
authors.initials: R
authors.lastname: Mikami
authors.forename: Koji
authors.initials: K
authors.lastname: Matsuo
authors.forename: Naoto
authors.initials: N
authors.lastname: Kawamura
authors.forename: Shintaro
authors.initials: S
authors.lastname: Fusagawa
mesh_terms: D001783:Blood Flow Velocity / Q000502:physiology; D002550:Cerebral Veins / Q000000981:diagnostic imaging / Q000503:physiopathology*; D002552:Cerebral Ventricles / Q000473:pathology; D005260:Female; D006801:Humans; D052577:Infant, Extremely Low Birth Weight; D007231:Infant, Newborn; D020300:Intracranial Hemorrhages / Q000000981:diagnostic imaging / Q000503:physiopathology*; D008297:Male; D008991:Monitoring, Physiologic / Q000379:methods*; D019370:Observation; D011446:Prospective Studies; D011673:Pulsatile Flow / Q000502:physiology; D017585:Ultrasonography, Doppler, Transcranial / Q000379:methods*; D014655:Vascular Resistance / Q000502:physiology; D014690:Venous Pressure / Q000502:physiology