Impaired Chemical Coupling of Cerebral Blood Flow Is Compatible with Intact Neurological Outcome in Neonates with Perinatal Risk Factors
Early detection of pathophysiological factors associated with permanent brain damage is a major issue in neonatal medicine. The aim of our study was to evaluate the significance of the CO 2 reactivity of cerebral blood flow (CBF) in neonates with perinatal risk factors. Fourteen ventilated neonates...
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Veröffentlicht in: | Biology of the neonate 1999-01, Vol.75 (1), p.9-17 |
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description | Early detection of pathophysiological factors associated with permanent brain damage is a major issue in neonatal medicine. The aim of our study was to evaluate the significance of the CO 2 reactivity of cerebral blood flow (CBF) in neonates with perinatal risk factors. Fourteen ventilated neonates with perinatal risk factors (pathological cardiotocogramm, low cord pH, postpartal encephalopathy) were enrolled into this prospective study. The study was performed 18–123 h after birth. CBF was measured using the nonivasive intravenous 133 Xe method. Two measurements were taken with a minimal PaCO 2 -difference of 5 mm Hg. From the two CBF values the CO 2 reactivity was calculated. Outcome was evaluated 1 year after birth. The CBF values at a lower PaCO 2 ranged from 6.6 to 115.2 ml/100 g brain issue/min (median = 18.2) and at a higher PaCO 2 level from 7.1 to 125.7 ml/100 g brain tissue/min (median = 18.75). The calculated CO 2 reactivity ranged from –9.6 to 6.6% (median 1.1%) change in CBF/mm Hg change in PaCO 2 . CO 2 reactivity correlated with lowest pH (r 2 = 0.35, p = 0.02). Two infants died, one of neonatal sepsis, the other of heart failure. Neurological outcome at the age of 1 year was normal in 11 patients, 1 had severe cerebral palsy. From the 12 surviving patients the patient with severe neurological deficit showed
the highest CBF values (125.7 ml/100 g/min). Impaired chemical coupling of cerebral blood flow is compatible with intact neurological outcome in neonates with perinatal risk factors. CO 2 reactivity in these newborns correlates with the lowest pH and may reflect the severity of perinatal asphyxia. |
doi_str_mv | 10.1159/000014072 |
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the highest CBF values (125.7 ml/100 g/min). Impaired chemical coupling of cerebral blood flow is compatible with intact neurological outcome in neonates with perinatal risk factors. CO 2 reactivity in these newborns correlates with the lowest pH and may reflect the severity of perinatal asphyxia.</description><subject>Anesthesia. Intensive care medicine. Transfusions. Cell therapy and gene therapy</subject><subject>Biological and medical sciences</subject><subject>Blood Flow Velocity</subject><subject>Brain - blood supply</subject><subject>Brain Diseases - diagnostic imaging</subject><subject>Brain Diseases - etiology</subject><subject>Brain Diseases - physiopathology</subject><subject>Cerebrovascular Circulation</subject><subject>Emergency and intensive care: neonates and children. Prematurity. 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Intensive care medicine. Transfusions. Cell therapy and gene therapy</topic><topic>Biological and medical sciences</topic><topic>Blood Flow Velocity</topic><topic>Brain - blood supply</topic><topic>Brain Diseases - diagnostic imaging</topic><topic>Brain Diseases - etiology</topic><topic>Brain Diseases - physiopathology</topic><topic>Cerebrovascular Circulation</topic><topic>Emergency and intensive care: neonates and children. Prematurity. Sudden death</topic><topic>Gestational Age</topic><topic>Heart Rate</topic><topic>Humans</topic><topic>Hydrogen-Ion Concentration</topic><topic>Infant, Newborn</topic><topic>Intensive care medicine</topic><topic>Kinetics</topic><topic>Medical sciences</topic><topic>Original Paper</topic><topic>Prognosis</topic><topic>Prospective Studies</topic><topic>Respiration, Artificial</topic><topic>Risk Factors</topic><topic>Ultrasonography</topic><topic>Umbilical Arteries</topic><topic>Xenon Radioisotopes</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Baenziger, Oskar</creatorcontrib><creatorcontrib>Moenkhoff, Marion</creatorcontrib><creatorcontrib>Morales, Cleo G.</creatorcontrib><creatorcontrib>Waldvogel, Katharina</creatorcontrib><creatorcontrib>Wolf, Martin</creatorcontrib><creatorcontrib>Bucher, Hans-Ulrich</creatorcontrib><creatorcontrib>Fanconi, Sergio</creatorcontrib><collection>Pascal-Francis</collection><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>ProQuest Central (Corporate)</collection><collection>Health & Medical Collection</collection><collection>ProQuest Central (purchase pre-March 2016)</collection><collection>Biology Database (Alumni Edition)</collection><collection>Medical Database (Alumni Edition)</collection><collection>Science Database (Alumni Edition)</collection><collection>ProQuest Pharma Collection</collection><collection>ProQuest SciTech Collection</collection><collection>ProQuest Natural Science Collection</collection><collection>Hospital Premium Collection</collection><collection>Hospital Premium Collection (Alumni Edition)</collection><collection>ProQuest Central (Alumni) (purchase pre-March 2016)</collection><collection>Research Library (Alumni Edition)</collection><collection>ProQuest Central (Alumni Edition)</collection><collection>ProQuest Central UK/Ireland</collection><collection>ProQuest Central Essentials</collection><collection>Biological Science Collection</collection><collection>ProQuest Central</collection><collection>Natural Science Collection</collection><collection>ProQuest One Community College</collection><collection>ProQuest Central Korea</collection><collection>Health Research Premium Collection</collection><collection>Health Research Premium Collection (Alumni)</collection><collection>ProQuest Central Student</collection><collection>Research Library Prep</collection><collection>SciTech Premium Collection</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>ProQuest Biological Science Collection</collection><collection>Health & Medical Collection (Alumni Edition)</collection><collection>Medical Database</collection><collection>Research Library</collection><collection>Science Database</collection><collection>Biological Science Database</collection><collection>Research Library (Corporate)</collection><collection>ProQuest One Academic Eastern Edition (DO NOT USE)</collection><collection>ProQuest One Academic</collection><collection>ProQuest One Academic UKI Edition</collection><collection>ProQuest Central China</collection><collection>ProQuest Central Basic</collection><collection>Bacteriology Abstracts (Microbiology B)</collection><collection>Neurosciences Abstracts</collection><collection>Environmental Sciences and Pollution Management</collection><collection>MEDLINE - Academic</collection><jtitle>Biology of the neonate</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Baenziger, Oskar</au><au>Moenkhoff, Marion</au><au>Morales, Cleo G.</au><au>Waldvogel, Katharina</au><au>Wolf, Martin</au><au>Bucher, Hans-Ulrich</au><au>Fanconi, Sergio</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Impaired Chemical Coupling of Cerebral Blood Flow Is Compatible with Intact Neurological Outcome in Neonates with Perinatal Risk Factors</atitle><jtitle>Biology of the neonate</jtitle><addtitle>Neonatology</addtitle><date>1999-01</date><risdate>1999</risdate><volume>75</volume><issue>1</issue><spage>9</spage><epage>17</epage><pages>9-17</pages><issn>1661-7800</issn><issn>0006-3126</issn><eissn>1661-7819</eissn><eissn>1421-9727</eissn><coden>BNEOBV</coden><abstract>Early detection of pathophysiological factors associated with permanent brain damage is a major issue in neonatal medicine. The aim of our study was to evaluate the significance of the CO 2 reactivity of cerebral blood flow (CBF) in neonates with perinatal risk factors. Fourteen ventilated neonates with perinatal risk factors (pathological cardiotocogramm, low cord pH, postpartal encephalopathy) were enrolled into this prospective study. The study was performed 18–123 h after birth. CBF was measured using the nonivasive intravenous 133 Xe method. Two measurements were taken with a minimal PaCO 2 -difference of 5 mm Hg. From the two CBF values the CO 2 reactivity was calculated. Outcome was evaluated 1 year after birth. The CBF values at a lower PaCO 2 ranged from 6.6 to 115.2 ml/100 g brain issue/min (median = 18.2) and at a higher PaCO 2 level from 7.1 to 125.7 ml/100 g brain tissue/min (median = 18.75). The calculated CO 2 reactivity ranged from –9.6 to 6.6% (median 1.1%) change in CBF/mm Hg change in PaCO 2 . CO 2 reactivity correlated with lowest pH (r 2 = 0.35, p = 0.02). Two infants died, one of neonatal sepsis, the other of heart failure. Neurological outcome at the age of 1 year was normal in 11 patients, 1 had severe cerebral palsy. From the 12 surviving patients the patient with severe neurological deficit showed
the highest CBF values (125.7 ml/100 g/min). Impaired chemical coupling of cerebral blood flow is compatible with intact neurological outcome in neonates with perinatal risk factors. CO 2 reactivity in these newborns correlates with the lowest pH and may reflect the severity of perinatal asphyxia.</abstract><cop>Basel, Switzerland</cop><pub>Karger</pub><pmid>9831679</pmid><doi>10.1159/000014072</doi><tpages>9</tpages></addata></record> |
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subjects | Anesthesia. Intensive care medicine. Transfusions. Cell therapy and gene therapy Biological and medical sciences Blood Flow Velocity Brain - blood supply Brain Diseases - diagnostic imaging Brain Diseases - etiology Brain Diseases - physiopathology Cerebrovascular Circulation Emergency and intensive care: neonates and children. Prematurity. Sudden death Gestational Age Heart Rate Humans Hydrogen-Ion Concentration Infant, Newborn Intensive care medicine Kinetics Medical sciences Original Paper Prognosis Prospective Studies Respiration, Artificial Risk Factors Ultrasonography Umbilical Arteries Xenon Radioisotopes |
title | Impaired Chemical Coupling of Cerebral Blood Flow Is Compatible with Intact Neurological Outcome in Neonates with Perinatal Risk Factors |
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