Elevated arterial blood pressure is associated with peri-intraventricular haemorrhage

Grönlund, Juhani; Korvenranta, Heikki; Kero, Pentti; Jalonen, J.; Välimäki, Ilkka

doi:10.1007/bf01972894

Cited by 41 publications

(22 citation statements)

References 36 publications

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“…This process produced 16 article,s which appeared likely to provide information about the relationship between BP and ultrasound brain abnormalities in the neonatal period. 8,13,14,[17][18][19][20][21][22][23][24][25][26][27][28][29][30] These articles are described in Table 1.…”

Section: Methodsmentioning

confidence: 99%

Treating hypotension in the preterm infant: when and with what: a critical and systematic review

2007

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A very large proportion of extremely preterm infants receive treatments for hypotension. There are, however, marked variations in indications for treatment, and in the interventions used, between neonatal intensive care units and between neonatologists.Methods: We performed systematic reviews of the literature in order to determine which preterm infants may benefit from treatment with interventions to elevate blood pressure (BP), and which interventions improve clinically important outcomes.Results: Our review was not able to define a threshold BP that was significantly predictive of a poor outcome, nor whether any interventions for hypotensive infants improved outcomes, nor which interventions were more likely to be beneficial. Conclusions:There is a distinct lack of prospective research of this issue, which prevents good clinical care. It is possible that a simple BP threshold that indicates the need for therapy does not exist, and other factors, such as the clinical status or systemic blood flow measurements, may be much more informative. Such a paradigm shift will also require careful prospective study.

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Section: Methodsmentioning

confidence: 99%

Treating hypotension in the preterm infant: when and with what: a critical and systematic review

2007

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“…Gronlund et al 16 sugerem que aumentos nas pressões sistólica, diastólica e média estão significativamente associados ao desenvolvimento da HPIV em recém-nascidos pré-termo. Tsuji et al 17 mostraram como o aumento da pressão arterial média estava associado às variações da oxigenação intravascular cerebral em prematuros criticamente doentes.…”

Section: Discussão E Conclusãounclassified

Efeitos da fisioterapia respiratória sobre a pressão arterial em recém-nascidos pré-termo

Nicolau

Falcão

2008

Fisioter. Pesqui.

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RESUMO: Oscilações na pressão arterial (PA) sistêmica são diretamente proporcionais às oscilações do fluxo sangüíneo cerebral nos prematuros, mas são escassos os estudos acerca do efeito dos procedimentos fisioterapêuticos sobre a PA. Este estudo investigou a repercussão desses procedimentos e da aspiração endotraqueal na pressão arterial em recém-nascidos pré-termo (RNPT) na primeira semana de vida. Foram estudados 42 RNPT com peso de nascimento menor que 1.500 gramas em ventilação mecânica. A PA foi mensurada em três momentos: antes da fisioterapia (A), imediatamente após os procedimentos fisioterapêuticos (B) e imediatamente após a aspiração endotraqueal (C). Os dados coletados foram analisados estatisticamente, com nível de signficância fixado em p<0,05. Os 42 RNPT tinham idade gestacional média de 29,58±2,16 semanas e peso médio ao nascer 1012,68±274,16 g, com predominância do sexo feminino (57,1%) e da doença das membranas hialinas (90,4%). As médias das variáveis estudadas, respectivamente pressão arterial sistólica, diastólica e (média), em mmHg, foram: momento A, 71,32 x 40,56 (53,04); momento B, 69,93 x 39,41 (51,98); e momento C, 74,29 x 43,75 (54,82). A PA dos recém-nascidos permaneceu dentro dos valores fisiológicos após os procedimentos fisioterapêuticos e de aspiração, portanto as intervenções fisioterapêuticas realizadas não podem ser consideradas prejudiciais para os RNPT; a aspiração endotraqueal teve maior influência nas oscilações da PA. DESCRITORES: Modalidades de fisioterapia; Monitoramento; Prematuro; Pressão arterial; Terapia intensiva neonatalABSTRACT: Blood pressure (BP) oscillations in premature newborns are directly related to cerebral blood flow, but few studies assess the effects of standard physical therapy procedures on their BP. The aim of this study was to analyse the effects of respiratory physiotherapy and endotracheal suctioning on premature newborn BP during the first week of life. Forty-two preterm newborns with mean birth weight of 101.68±274.16 g, mean gestational age 29.58±2.16 weeks, and receiving mechanical ventilation were studied; they were mostly female (57.1%) and presented hyaline membrane disease (90.4%). BP measurements were carried out at three moments: before (A) and after physiotherapy (B), and after endotracheal suctioning (C Newborn BP thus remained within physiological values both after physiotherapy procedures and suctioning, hence these may be said to be harmless; endotracheal suctioning had a higher influence on premature newborn BP oscillations.

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“…Not surprisingly, this relationship has resulted in conflicting evidence implicating high, low and fluctuant arterial blood pressure (ABP) as contributors to neonatal brain injury. [1][2][3][4][5][6][7][8] Recently, the preponderance of this data has shown that low ABP is associated with neurologic injury, but optimal hemodynamic management of the premature infant remains elusive.…”

Section: Introductionmentioning

confidence: 99%

Relationship between cerebrovascular dysautoregulation and arterial blood pressure in the premature infant

et al. 2011

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Objective: To evaluate cerebrovascular autoregulation as a function of arterial blood pressure (ABP) in the critically ill, premature infant.Study Design: A prospective observational pilot study was conducted in two tertiary care Neonatal Intensive-Care Units. Premature infants (n ¼ 23, p30 weeks estimated gestational age with invasive ABP monitoring) were enrolled and received routine care while undergoing continuous autoregulation monitoring, using the cerebral oximetry index (COx). The COx is a moving, linear correlation coefficient between cortical reflectance oximetry and ABP. COx values were stratified as a function of ABP for individual subject recordings and for the cohort.Result: The mean duration of autoregulation monitoring was 3.2 days (median: 2.97, range: 0.61-3.99). A total of 10 of 23 (43%) developed intraventricular hemorrhage and 1 of 23 (4%) developed periventricular leukomalacia by head ultrasound. No association was found between neurologic injury and percentage of the monitoring periods with autoregulation impairment (defined as COx>0.5). Lower ABP was associated with dysautoregulation (higher COx values, P<0.01). The percentage of time with impaired autoregulation was greater with lower ABP (P ¼ 0.013, Spearman r ¼ 0.51).Conclusion: All infants studied had periods with intact and periods with impaired cerebrovascular autoregulation, measured with the COx. Low ABP was associated with impaired autoregulation.

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Elevated arterial blood pressure is associated with peri-intraventricular haemorrhage

Abstract: Our results suggest that elevated diastolic, mean and systolic blood pressure are significantly associated with peri-intraventricular haemorrhage in preterm newborn infants.

Cited by 41 publications

References 36 publications

Treating hypotension in the preterm infant: when and with what: a critical and systematic review

Treating hypotension in the preterm infant: when and with what: a critical and systematic review

Efeitos da fisioterapia respiratória sobre a pressão arterial em recém-nascidos pré-termo

Relationship between cerebrovascular dysautoregulation and arterial blood pressure in the premature infant

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