Cerebral blood flow in preterm infants affected by sex, mechanical ventilation, and intrauterine growth

Baenziger, Oskar; Jaggi, Jurg L.; Mueller, Anita C.; Morales, Cleo G.; Lipp, Hans‐Peter; Lipp, A; Duc, Gabriel; Bucher, H. U.

doi:10.1016/0887-8994(94)90009-4

Cited by 60 publications

(43 citation statements)

References 25 publications

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“…Our study showed that mechanical ventilation or gender did not have an important effect on the PC-MRA measured CBF values. These results do not confirm results of a former study investigating CBF with the 133 Xenon clearance method, although those infants were more preterm infants and the range of postnatal ages was less (25).…”

Section: Discussioncontrasting

confidence: 56%

“…However, the PC-MRA measured CBF per kilogram actual body weight seemed to be remarkable stable over a wide range of postconceptional ages. Our data do not confirm an earlier study in neonates, which reported that mechanical ventilation, gender, and growth retardation negatively affected 133 Xenonmeasured CBF (mL/100 gm/min) (25). Because quantitative CBF data in newborns are rare, it is important that evidence is added to existing knowledge with this PC-MRA technique.…”

Section: Discussioncontrasting

confidence: 56%

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Phase-Contrast Magnetic Resonance Angiography Measurements of Global Cerebral Blood Flow in the Neonate

et al. 2011

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Cerebral blood flow (CBF) alterations are important in pathogenesis of neonatal ischemic/hemorrhagic brain damage. In clinical practice, estimation of neonatal CBF is mostly based on Doppler-measured blood flow velocities in major intracranial arteries. Using phase-contrast magnetic resonance angiography (PC-MRA), global CBF can be estimated, but there is limited neonatal experience. The objective of this study was to gain experience with PC-MRA for the determination of global CBF in neonates. In infants eligible for MRI, PC-MRA global CBF was determined by measuring volume blood flow in both internal carotid arteries (ICAs) and basilar artery (BA). Thirty newborns (GA, 25.7-42.1 wk; weight, 1050 -5858 g; postconceptional age, 225-369 d) were investigated. Total PC-MRA CBF ranged from 27 to 186 mL/min. Significant correlations between PC-MRA CBF and postconceptional age and weight were detected. When calculating PC-MRA measured CBF per kilogram body weight, brain perfusion was about stable over the range of postconceptional ages and ranged between 11 and 48 mL/min/kg (median, 25 mL/min/kg). In conclusion, neonatal PC-MRA CBF seems to be a useful technique to estimate noninvasive CBF. (Pediatr Res 69: 544-547, 2011) P revious studies of (changes in) neonatal cerebral blood flow (CBF) have been performed using different methods, such as the venous occlusion plethysmography (1), positron emission tomography (2), the nitrous oxide technique (3), and the 133 Xenon clearance method (4). In addition, Xenon computed tomography (5) and more recently MRI with contrast (6) have been used to measure neonatal CBF. Furthermore, the use of near-infrared spectroscopy (NIRS) with indocyanine green has been repeatedly reported, but it uses an i.v. injection with the dye indocyanine green (7). Ionizing radiation is involved in these techniques or they are invasive or need special requirements, which limit their use. Arterial spinlabeled perfusion MRI (8) and sophisticated NIRS techniques such as optical diffuse correlation spectroscopy are developed at this moment to evaluate neonatal CBF (9); however, improvements are necessary before these devices can reliably be used. It may be clear that the above-mentioned methods are not (yet) available for clinical use in the vulnerable and unstable (preterm) neonate.Noninvasive approaches for estimating changes in global CBF in the often unstable neonate are performed using NIRS and Doppler-derived blood flow velocity measurements in the major intracranial arteries (10 -14). NIRS as such has not yet become a routine application in the NICUs, whereas measurements of blood flow velocity in intracranial arteries cannot measure volume flow due to the small diameter of the feeding intracranial arteries in newborn infants (5,12).MRI is increasingly used in neonates both in preterm as well as in full term infants, mainly for depicting the various brain regions to detect subtle differences or early ischemic and/or hemorrhagic changes due to perinatal complications (15,16). Recently, usin...

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Section: Discussioncontrasting

confidence: 56%

Section: Discussioncontrasting

confidence: 56%

Phase-Contrast Magnetic Resonance Angiography Measurements of Global Cerebral Blood Flow in the Neonate

et al. 2011

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“…Baenziger et al (1994) also reported higher CBF in male than female infants. Using SPECT, they determined that premature males have significantly higher CBF than females.…”

Section: Discussionmentioning

confidence: 86%

Regional and Hemispheric Asymmetries of Cerebral Hemodynamic and Oxygen Metabolism in Newborns

Lin

Dehaes

Roche-Labarbe

et al. 2012

Biomedical Optics and 3-D Imaging

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Understanding the evolution of regional and hemispheric asymmetries in the early stages of life is essential to the advancement of developmental neuroscience. By using 2 noninvasive optical methods, frequency-domain near-infrared spectroscopy and diffuse correlation spectroscopy, we measured cerebral hemoglobin oxygenation (SO 2 ), blood volume (CBV), an index of cerebral blood flow (CBF i ), and the metabolic rate of oxygen (CMRO 2i ) in the frontal, temporal, and parietal regions of 70 premature and term newborns. In concordance with results obtained using more invasive imaging modalities, we verified both hemodynamic (CBV, CBF i , and SO 2 ) and metabolic (CMRO 2i ) parameters were greater in the temporal and parietal regions than in the frontal region and that these differences increased with age. In addition, we found that most parameters were significantly greater in the right hemisphere than in the left. Finally, in comparing age-matched males and females, we found that males had higher CBF i in most cortical regions, higher CMRO 2i in the frontal region, and more prominent right--left CBF i asymmetry. These results reveal, for the first time, that we can detect regional and hemispheric asymmetries in newborns using noninvasive optical techniques. Such a bedside screening tool may facilitate early detection of abnormalities and delays in maturation of specific cortical areas.

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“…Infelizmente a maior parte dos estudos sobre a influência desta alteração foi e continua sendo realizada em fetos. No período pós-parto, além de dados escassos, a literatura tem mostrado valores bastante diversificados de fluxo cerebral, não só em relação à adequação peso/idade, mas também frente a outras variáveis [12][13][14][15][16]25 .…”

Section: E S T a D O N U T R I C I O N A Lunclassified

“…Também não foi encontrada diferença em relação ao sexo, entretanto, apenas um estudo relatou que o sexo é fator de influência no FSC, com menor velocidade de FSC no sexo feminino, provavelmente por alterações hormonais e diferenças na viscosidade sanguínea e no débito cardíaco 25 .…”

Section: E S T a D O N U T R I C I O N A Lunclassified

Velocimetria Doppler no período neonatal em recém-nascidos a termo pequenos para idade gestacional

Muniz

Netto

Gonçalves

2003

Arq. Neuro-Psiquiatr.

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RESUMO -Este estudo teve como objetivo avaliar o fluxo sanguíneo cerebral em recém-nascidos a termo pequenos para idade gestacional, utilizando ultra-sonografia Doppler craniana ao nascimento. O estudo foi desenvolvido no CAISM/UNICAMP (Centro de Saúde Terciário para Mulheres). Foram selecionados sessenta recém-nascidos e divididos em 2 grupos: 36 adequados para idade gestacional (AIG) e 24 pequenos para idade gestacional (PIG). Foi realizada a avaliação de ultra-sonografia Doppler craniana nos grupos, entre 24-48 horas após o nascimento. A velocidade de fluxo sanguíneo cerebral foi menor no grupo PIG na artéria cerebral anterior (ACA). As medidas Doppler foram estatisticamente diferentes entre os grupos apenas para valores relacionados à velocidade de fluxo de pico sistólico (VFPS) e velocidade de fluxo médio (VFM) na ACA. Não houve diferenças significantes para nenhum dos parâmetros avaliados de velocidade de fluxo na artéria cerebral média (ACM). Concluiu-se que recém-nascidos PIG apresentaram VFPS e VFM significativamente menores apenas na ACA. A adequação peso/ idade gestacional, presença de policitemia neonatal e valores de pressão arterial média estiveram estatisticamente associados a VFM na ACA. A presença de sofrimento fetal, valores de pressão arterial média e hábito de fumar durante a gestação estiveram estatisticamente associados a VFM na ACM.PALAVRAS-CHAVE: Doppler-ultra-sonografia craniana, desnutrição intra-uterina, recém-nascido.Neonatal Doppler velocimetry in full term small-for Neonatal Doppler velocimetry in full term small-for Neonatal Doppler velocimetry in full term small-for Neonatal Doppler velocimetry in full term small-for Neonatal Doppler velocimetry in full term small-for-gestational age newborns -gestational age newborns -gestational age newborns -gestational age newborns -gestational age newbornsABSTRACT -This study aimed to evaluate the cerebral blood flow of full term small-for-gestational age newborns, using cranial ultrasound Doppler at birth. This study was performed at CAISM/UNICAMP (Tertiary Health Center for Women). Sixty term newborns were selected and divided in two groups: appropriate-for-gestational age (AGA) (36 neonates) and small-for-gestational age (SGA) (24 neonates). Cranial ultrasound Doppler evaluation was performed on both groups, between 24 and 48 hours after birth. Cerebral blood flow velocity (CBFV) was lower in the small-for-gestational age group, in the anterior cerebral artery (ACA). Doppler measurements were different statistically between the groups only for values related to peak systolic flow velocity (PSFV) and mean flow velocity (MFV) in the ACA. There was no significant difference for any evaluated parameters of flow velocity in the middle cerebral artery (MCA). It was concluded that SGA newborns showed PSFV and MFV significantly reduced only in the ACA. Weight/gestational age, neonatal polycythemia and mean arterial blood pressure values were statistically related to MFV in the ACA. In presence of fetal suffering, mean arterial blood pressure value...

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Cerebral blood flow in preterm infants affected by sex, mechanical ventilation, and intrauterine growth

Cited by 60 publications

References 25 publications

Phase-Contrast Magnetic Resonance Angiography Measurements of Global Cerebral Blood Flow in the Neonate

Phase-Contrast Magnetic Resonance Angiography Measurements of Global Cerebral Blood Flow in the Neonate

Regional and Hemispheric Asymmetries of Cerebral Hemodynamic and Oxygen Metabolism in Newborns

Velocimetria Doppler no período neonatal em recém-nascidos a termo pequenos para idade gestacional

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