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Relationship between blood pressure, cerebral electrical activity, cerebral fractional oxygen extraction, and peripheral blood flow in very low birth weight newborn infants.

Title: Relationship between blood pressure, cerebral electrical activity, cerebral fractional oxygen extraction, and peripheral blood flow in very low birth weight newborn infants.
Authors: Victor, Suresh; Marson, AG; Appleton, RE; Beirne, M; Weindling, AM
Source: Victor, S, Marson, AG, Appleton, RE, Beirne, M & Weindling, AM 2006, 'Relationship between blood pressure, cerebral electrical activity, cerebral fractional oxygen extraction, and peripheral blood flow in very low birth weight newborn infants.', Pediatric Research, vol. 59, no. 2, pp. 314-9. https://doi.org/10.1203/01.pdr.0000199525.08615.1f
Publication Year: 2006
Collection: King's College, London: Research Portal
Description: There is uncertainty about the level of systemic blood pressure required to maintain adequate cerebral oxygen delivery and organ integrity. This prospective, observational study on 35 very low birth weight infants aimed to determine the mean blood pressure (MBP) below which cerebral electrical activity, peripheral blood flow (PBF), and cerebral fractional oxygen extraction (CFOE) are abnormal. Digital EEG, recorded every day on the first 4 d after birth, were analyzed a) by automatic spectral analysis, b) by manual measurement of interburst interval, and c) qualitatively. CFOE and PBF measurements were performed using near-infrared spectroscopy and venous occlusion. MBP was measured using arterial catheters. The median (range) of MBP recorded was 32 mm Hg (16-46). The EEG became abnormal at MBP levels below 23 mm Hg: a) the relative power of the delta (0.5-3.5 Hz) frequency band was decreased, b) interburst intervals were prolonged, and c) all four qualitatively abnormal EEG (low amplitude and prolonged interburst intervals) from four different patients were recorded below this MBP level. The only abnormally high CFOE was measured at MBP of 20 mm Hg. PBF decreased at MBP levels between 23 and 33 mm Hg. None of the infants in this study developed cystic periventricular leukomalacia. One infant (MBP, 22 mm Hg) developed ventricular dilatation after intraventricular hemorrhage. The EEG and CFOE remained normal at MBP levels above 23 mm Hg. It would appear that cerebral perfusion is probably maintained at MBP levels above 23 mm Hg.
Document Type: article in journal/newspaper
Language: English
ISSN: 0031-3998
Relation: info:eu-repo/semantics/altIdentifier/pissn/0031-3998
DOI: 10.1203/01.pdr.0000199525.08615.1f
Availability: https://kclpure.kcl.ac.uk/portal/en/publications/956299d8-ae02-4731-a557-4f34909255fc; https://doi.org/10.1203/01.pdr.0000199525.08615.1f; http://www.nature.com/pr/journal/v59/n2/full/pr200662a.html
Rights: info:eu-repo/semantics/closedAccess
Accession Number: edsbas.4129617C
Database: BASE