Pathophysiology of Intraventricular Hemorrhage in the Neonate

Inder, Terrie E.; Volpe, Joseph J.

doi:10.1016/b978-0-7216-9654-6.50174-0

Cited by 4 publications

(7 citation statements)

References 230 publications

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“…Cerebral blood flow provides the brain with glucose and oxygen necessary for brain development 5 and for infants born less than 32 weeks gestation, fluctuations in cerebral blood flow can result in cerebral damage. 6 Auditory stimulation from the NICU environment could disrupt the pathway of neurological signals in the less mature brain, 7 which could eventually alter the distribution of cerebral blood flow to the brain and potentially result in cerebral damage. Particular head and body positions such as a turned head or lying prone may reduce, or reduce and then increase, blood flow to the brain.…”

mentioning

confidence: 99%

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The Effects of Environmental Noise and Infant Position on Cerebral Oxygenation

Elser

Holditch‐Davis²,

Levy³

et al. 2012

Advances in Neonatal Care

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Purpose To assess how different infant positions and peak sound levels effected cerebral oxygen saturation over time. Subjects Twenty-four premature infants who were born less than 32 weeks gestational age without congenital cardiac, neurological, and gastrointestinal anomalies. Design Repeated measures design with the first observation between 2 and 48 hours of life; once again between 49 and 96 hours of life; on Day of Life 7; and every 7 days thereafter until discharge home, transfer to another hospital, or 40 weeks post-menstrual age, whichever came first. Methods Continuous sound levels (decibels) were obtained and two infant positions were performed while measuring cerebral oxygen saturation during 40-minute observation periods. Main outcome measures Effect of peak sound and differences in infant position on cerebral oxygen saturation. Principal results Peak sound levels 5 decibels above the average ambient sound level did not significantly change cerebral oxygen saturation values. Differences in cerebral oxygenation were significantly less when infants were changed from a supine, head midline position to a right lateral, 15° head elevation compared to a left lateral, 0° elevation position. Conclusions Aspects of the current NICU environment do not appear to affect cerebral oxygen saturation.

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mentioning

confidence: 99%

“…An increased understanding about changes in cerebral oxygen saturation during position changes or loud sounds may permit the development of interventions to prevent severe fluctuations in cerebral blood flow that are hypothesized to result in cerebral damage. 6 …”

mentioning

confidence: 99%

The Effects of Environmental Noise and Infant Position on Cerebral Oxygenation

Elser

Holditch‐Davis²,

Levy³

et al. 2012

Advances in Neonatal Care

View full text Add to dashboard Cite

show abstract

“…21 Marked areas of necrotic cerebral tissue distinguish PVL from other neurological diagnoses and results from episodes of ischemia often due to low blood pressure. 22 No real-time measure exists to identify infants with impaired autoregulation.…”

Section: Vulnerability To Ivh and Pvlmentioning

confidence: 99%

“…26 Yet how cerebral oxygenation develops overtime is unknown. The fluctuations in cerebral blood flow place premature infants at risk for IVH 21 , particularly in the first week of life, and PVL. As cerebral blood flow increases oxygen delivery to meet higher oxygen demands, cerebral oxygenation will also increase.…”

Section: Development Of Cerebral Blood Flow and Oxygenationmentioning

confidence: 99%

“…33 Doppler ultrasound and cerebral oximetry are non-invasive, indirect measures of cerebral blood flow in infants. 33 Doppler ultrasound focuses on provider selected cerebral arteries or veins to measure cerebral blood flow 21 , but it requires an ultrasound technician at the bedside to gather data that must then be interpreted by a radiologist. 34 In addition, studies utilizing Doppler ultrasound do not provide guidance for continuous clinical decision-making.…”

Section: Measurement Of Cerebral Blood Flow and Cerebral Oxygenationmentioning

confidence: 99%

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Cerebral Oxygenation Monitoring: A Strategy to Detect Intraventricular Hemorrhage and Periventricular Leukomalacia

Elser

Holditch‐Davis

Brandon

2011

Newborn and Infant Nursing Reviews

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Premature infants are at risk for intraventricular hemorrhage (IVH) and periventricular leukomalacia (PVL) theorized to be a result from fluctuations in cerebral blood flow. Monitoring cerebral oxygenation offers a method to observe changes in cerebral blood flow that may be beneficial for detecting and preventing IVH and PVL. This article explains the potential for cerebral oxygenation monitoring in detecting IVH and PVL using cerebral oximetry, reviews current knowledge known about cerebral oxygenation, and describes current challenges for cerebral oxygenation to be the next neuroprotective vital sign.

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Late intraventricular hemorrhage in preterm infants

Vartanian

Attar

Donn

et al. 2012

Journal of Neonatal-Perinatal Medicine

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Objective: To determine the likelihood of intraventricular hemorrhage (IVH) occurring after the first three days of life and to develop a predictive model for late IVH in preterm infants.Methods: A retrospective study was conducted on very low birth weight infants with grades IVH II-IV. IVH was considered early if detected by ultrasound within the first three days of life and it was considered late if detected beyond this time. Infants with late IVH had at least one documented negative ultrasound scan on or after day of life three. Data were evaluated for associated risk factors using univariate and logistic regression analyses.Results: One-hundred thirty infants with IVH grades II-IV met the inclusion criteria. Early IVH occurred in 82 (63%) and late IVH occurred in 48 (37%). Infants with late IVH were more commonly exposed to prenatal steroids (OR 4.2, 95% CI 1.5-12.0), cesarean delivery (OR 2.8, 95% CI 1.1-7.0), or had symptomatic PDA requiring medical or surgical therapy prior to IVH detection (OR 12.0, 95% CI 3.8-37.7) compared to infants with early IVH.Conclusions: IVH after day of life three is not rare in VLBW infants. Further exploration of risk factors associated with late IVH compared to infants without IVH through interventional trials is warranted.

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Pathophysiology of Intraventricular Hemorrhage in the Neonate

Cited by 4 publications

References 230 publications

The Effects of Environmental Noise and Infant Position on Cerebral Oxygenation

The Effects of Environmental Noise and Infant Position on Cerebral Oxygenation

Cerebral Oxygenation Monitoring: A Strategy to Detect Intraventricular Hemorrhage and Periventricular Leukomalacia

Late intraventricular hemorrhage in preterm infants

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