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
Hauptverfasser: Baenziger, Oskar, Moenkhoff, Marion, Morales, Cleo G., Waldvogel, Katharina, Wolf, Martin, Bucher, Hans-Ulrich, Fanconi, Sergio
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container_end_page 17
container_issue 1
container_start_page 9
container_title Biology of the neonate
container_volume 75
creator Baenziger, Oskar
Moenkhoff, Marion
Morales, Cleo G.
Waldvogel, Katharina
Wolf, Martin
Bucher, Hans-Ulrich
Fanconi, Sergio
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.
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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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