Abnormal cerebral haemodynamics in perinatally asphyxiated neonates related to outcome
Judith H Meeka, Clare E Elwellb, David C McCormickc, A David Edwardsd, Janice P Townsenda, Ann L Stewarta, John S Wyatta
a Department of
Paediatrics The Rayne Institute
University College London Medical School
London WC1E 6JJ, b Department of Medical Physics and Bioengineering, c Department of Paediatrics
Kent and Canterbury Hospital
Canterbury, d Department of Paediatrics and Neonatal Medicine
Royal Postgraduate Medical School
Hammersmith Hospital
London
Correspondence to: Dr Judith Meek. Email: j.meek{at}ucl.ac.uk
Accepted 26 April 1999
AIM
To measure changes
in cerebral haemodynamics during the first 24 hours of life following
perinatal asphyxia, and relate them to outcome.
METHODSCerebral blood
volume (CBV), its response (CBVR) to changes in arterial carbon dioxide
tension (PaCO2), and cerebral blood flow (CBF) were
measured using near infrared spectroscopy (NIRS) in 27 term newborn
infants with clinical and/or biochemical evidence consistent with
perinatal asphyxia.
RESULTSBoth CBF and
CBV were higher on the first day of life in the infants with adverse
outcomes, and a CBV outside the normal range had a sensitivity of 86%
for predicting death or disability. The mean (SD) CBVR on the first day
of life was 0.13 (0.12) ml/100 g/1/kPa, which, in 71% of infants, was
below the lower 95% confidence limit for normal subjects.
CONCLUSIONAn increase
in CBV on the first day of life is a sensitive predictor of adverse
outcome. A reduction in CBVR is almost universally seen following
asphyxia, but is not significantly correlated with severity of adverse outcome.
Keywords: perinatal asphyxia; cerebral haemodynamics
© 1999 by Archives of Disease in Childhood
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