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Archives of Disease in Childhood - Fetal and Neonatal Edition 1999;81:F110-F115; doi:10.1136/fn.81.2.F110
Copyright © 1999 BMJ Publishing Group Ltd & Royal College of Paediatrics and Child Health.
Arch Dis Child Fetal Neonatal Ed 1999;81:F110-F115 ( September )

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.
METHODS---Cerebral 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.
RESULTS---Both 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.
CONCLUSION---An 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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