Objective. The purpose of this study was to evaluate the changes in Doppler blood flow velocity (BFV) in cerebral and visceral arteries during infancy. Methods. The BFV was measured in 37 healthy term neonates in the anterior cerebral artery (ACA), middle cerebral artery (MCA), basilar artery, internal carotid artery (ICA), celiac artery (CA), superior mesenteric artery (SMA), and renal artery (RA). Results. The mean BFV increased and the resistive index decreased (P < .05) in all cerebral arteries, SMA, and CA by the age of 12 to 23.9 hours and in the RA by the age of 24 to 35.9 hours compared with 2 to 11.9 hours. A further significant increase (P < .05) of the mean BFV occurred in all arteries except the ICA and CA by the age of 72 to 120 hours compared with 12 to 23.9 hours. By the age of 21 to 59 days, the mean BVF doubled in all investigated arteries compared with 2 to 11.9 hours, with a further significant increase (P < .05) by the age of 150 to 240 days in cerebral and renal arteries. There was no correlation between the mean blood pressure (BP) and mean BFV in the ACA and MCA. However, there was a positive correlation (r ≥ 0.5; P < .05) between the BP and BFV in the RA and SMA at the age of 12 to 23.9 hours. Conclusions. A significant increase in the cerebral and visceral BFV occurs normally throughout infancy, with the visceral BFV affected by BP changes during the first day of life. Key words: cerebral blood flow velocity; neonate; sonography; visceral blood flow velocity. oppler sonography is a noninvasive method that allows repeated and safe assessment of hemodynamics in neonatal units. Several studies have shown that a pulsed Doppler technique can be used to examine the pattern of blood flow velocity (BFV) in major vessels of the brain 1 as well as visceral organs 2 in neonates with good reproducibility. Several studies have followed the BFV in different cerebral 3-6 and visceral 7-11 arteries during cardiovascular adaptation of the neonate within the first week of life. These studies typically evaluated a single organ. A few cross-sectional studies have followed the changes of the cerebral BFV in neonates up to the first 20 days of life 12 and infants older than 30 days. 13,14 Cross-sectional studies of the BFV in renal arteries have also been performed in infants older than 30 days. 7,[15][16][17] To our knowledge there have been no studies looking at the normal preprandial splanchic BFV in infants older than 1 month.
The high mean CBFV found in infants with severe HIE during the first days after asphyxia is temporary and low CBFV and head circumference develops by the age of 21-59 days.
Objective. The purpose of this study was to evaluate changes in the Doppler blood flow velocity (BFV) in the cerebral and visceral arteries in asphyxiated term neonates. Methods. The BFV was measured in 47 asphyxiated and 37 healthy term neonates in the anterior cerebral artery, middle cerebral artery, basilar artery, internal carotid artery, celiac artery (CA), superior mesenteric artery (SMA), and renal artery (RA) up to the age of 60 to 149 days. Results. At the age of 12 to 120 hours after asphyxia, the mean BFV had increased, and the resistive index (RI) had decreased (P < .05) in all cerebral arteries in neonates with severe hypoxic-ischemic encephalopathy (HIE) compared with the control group. In neonates with severe HIE, the mean BFV in the RA had significantly decreased at the age of 3 to 240 hours, and the RI had increased at the age of 24 to 240 hours, normalizing by the age of 21 to 59 days compared with the control group (P < .05). In the SMA, a decreased mean BFV was found in neonates with severe HIE compared with those with mild to moderate HIE only at the age of 24 to 36 hours. In neonates with mild to moderate HIE, the mean BFV had increased in the SMA and CA compared with the control group at the age of 2 to 11.9 hours. Conclusions. A severe alteration of the cerebral and visceral BFV takes place during the first days after asphyxia in neonates with different severities of HIE. Key words: cerebral blood flow velocity; hypoxic-ischemic encephalopathy; neonate; sonography; visceral blood flow velocity. irth asphyxia remains a major cause of neonatal morbidity and infant mortality worldwide, with multiple-organ failure developing in 50% to 60% of severely asphyxiated infants. 1,2 Hypoxicischemic encephalopathy (HIE) occurring during the perinatal period is one of the most commonly recognized causes of severe long-term neurologic deficits in children.2 The severity of the encephalopathy predicts the risk of death and long-term neurodisability.3-5 The central nervous system is disturbed in 70% of neonates after severe birth asphyxia 6 ; however, asphyxia is likely to cause disturbances in a number of organ systems other than the brain. Renal involvement occurred in 40% to 50%, pulmonary involvement in 25%, cardiac involvement in 25% to 30%, and gastrointestinal involvement in 30% of the cases of asphyxiated term neonates. 1,6 Others showed a higher proportion of neonates with renal, pulmonary, cardiac, and liver dysfunction: in 58% to 88% of
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