The DOI matches its Crossref record; 22 of the 22 references it cites were found in a registry or an index.
Hypotensive Extremely Low Birth Weight Infants Have Reduced Cerebral Blood Flow
Abstract
Objectives. Whether extremely low birth weight (ELBW) infants are at risk of cerebral hypoperfusion is uncertain because key issues concerning their cerebral blood flow (CBF) and mean arterial pressure (MAP) are unresolved: (1) whether CBF is pressure-passive or autoregulated; (2) the normal level of MAP; and (3) whether inotropic drugs used to increase MAP might inadvertently impair CBF. We addressed these issues in ELBW infants undergoing intensive care. Methods. CBF (measured by near-infrared spectroscopy) and MAP were measured in 17 infants aged 1.5 to 40.5 hours. Results. Five infants remained normotensive (MAP 37 ± 2 mm Hg, [mean ± SEM]); twelve became hypotensive (MAP 25 ± 1 mm Hg) and were treated with dopamine (10–30 μg · kg−1 per min). CBF of hypotensive infants (14 ± 1 mL · 100 g−1 per min) was lower than the CBF of normotensive infants (19 ± mL · 100 g−1 per min). After commencement of dopamine in hypotensive infants, MAP increased (29 ± 1 mm Hg) and CBF also increased (18 ± 1 mL · 100g−1 per min). CBF was correlated with MAP in hypotensive infants before (R = 0.62) and during (R = 0.67) dopamine, but not in normotensive infants. A breakpoint was identified in the CBF versus MAP autoregulation curve of untreated infants at MAP = 29 mm Hg; no breakpoint was evident in dopamine-treated infants. Conclusions. In ELBW infants (1) cerebral autoregulation is functional in normotensive but not hypotensive infants; (2) a breakpoint exists at ∼30 mm Hg in the CBF-MAP autoregulation curve; and (3) dopamine improves both MAP and CBF.
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Cites
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Impaired autoregulation of cerebral blood flow in the distressed newborn infant
Lou, H. C., Lassen, N. A., & Friis-Hansen, B. (1979) · The Journal of Pediatrics · doi:10.1016/s0022-3476(79)80373-x · Cited by 642
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Low superior vena cava flow and intraventricular haemorrhage in preterm infants
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COTSIDE MEASUREMENT OF CEREBRAL BLOOD FLOW IN ILL NEWBORN INFANTS BY NEAR INFRARED SPECTROSCOPY
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Blood pressure and cerebral haemorrhage and ischaemia in very low birthweight infants
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Cited by
Brierley, J., Carcillo, J. A., Choong, K., Cornell, T., DeCaen, A., Deymann, A., Doctor, A., Davis, A., Duff, J., Dugas, M.-A., et al. (2009) · Critical Care Medicine · doi:10.1097/ccm.0b013e31819323c6 · Cited by 1,073
Impaired Autoregulation in Preterm Infants Identified by Using Spatially Resolved Spectroscopy
Wong, F. Y., Leung, T. S., Austin, T., Wilkinson, M., Meek, J. H., Wyatt, J. S., & Walker, A. M. (2008) · Pediatrics · doi:10.1542/peds.2007-1487 · Cited by 256
Self-citationFicial, B., Finnemore, A. E., Cox, D. J., Broadhouse, K. M., Price, A. N., Durighel, G., Ekitzidou, G., Hajnal, J. V., Edwards, A. D., & Groves, A. M. (2013) · Journal of the American Society of Echocardiography · doi:10.1016/j.echo.2013.08.019 · Cited by 102
Hypoxic-Ischemic encephalopathy and therapeutic hypothermia: the hemodynamic perspective
Giesinger, R. E., Bailey, L. J., Deshpande, P., & McNamara, P. J. (2017) · The Journal of Pediatrics · doi:10.1016/j.jpeds.2016.09.009 · Cited by 92
Metadata
- Authors
- Munro, M. J., Walker, A. M., & Barfield, C. P.
- Venue
- Pediatrics
- Publisher
- American Academy of Pediatrics (AAP)
- Published
- 2004-12-01
- Volume
- 114
- Issue
- 6
- Pages
- 1591-1596
- ISSN
- 0031-4005 (ISSN-L)
- 1098-4275
- OpenAlex
- W1979577049
- Cited by
- 268
- References
- 22
- FWCI
- 7.27
- Type
- journal article
- Language
- en
- Open access
- closed
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