title: Hemodynamic antecedents of peri/intraventricular hemorrhage in very preterm neonates.
abstract: Novel hemodynamic monitoring technologies have contributed to the understanding of developmental cardiovascular physiology and pathophysiology in general, and of developmental hemodynamics in particular. Hemodynamic disturbances play a significant role in the pathogenesis of peri/intraventricular hemorrhage (P/IVH) in preterm infants. Immaturity of the myocardium, delayed and incomplete cardiopulmonary transition, sustained patency of the ductus arteriosus, and unintended consequences of respiratory and cardiovascular supportive care are all likely to be involved in the presentation of low cardiac output syndrome and decreased organ blood flow in a large number of very preterm neonates (gestational age ≤28 weeks). Forebrain vessels in very preterm infants may not have achieved a "high-priority vasculature" status at the time of delivery; in these patients, forebrain perfusion is not protected during the compensated phase of shock. Reperfusion may be attenuated by the careful use of medications decreasing cerebrovascular reactivity, thus providing a potential target for the development of careful pharmacological support of transitional hemodynamics in selected patients at high risk for the development of P/IVH.
authors.affiliation: Division of Neonatology and the Center for Fetal and Neonatal Medicine, Department of Pediatrics, Children's Hospital Los Angeles and the LAC+USC Medical Center, Keck School of Medicine, University of Southern California, Los Angeles, CA, USA. Electronic address: snoori@chla.usc.edu.
authors.forename: Shahab
authors.initials: S
authors.lastname: Noori
authors.affiliation: Sidra Medical and Research Center, Doha, Qatar.
authors.forename: Istvan
authors.initials: I
authors.lastname: Seri
mesh_terms: D002318:Cardiovascular Diseases / Q000503:physiopathology*; D002543:Cerebral Hemorrhage / Q000503:physiopathology*; D002560:Cerebrovascular Circulation / Q000502:physiology; D005260:Female; D006439:Hemodynamics; D006801:Humans; D007223:Infant; D062071:Infant, Extremely Premature / Q000502:physiology*; D007235:Infant, Premature, Diseases / Q000503:physiopathology*; D011247:Pregnancy
keywords: Cerebral blood flow; Cerebral oxygenation; Echocardiography; Hemodynamic monitoring; Near-infrared spectroscopy; Patent ductus arteriosus