Response of Cerebral Blood Volume to Changes in Arterial Carbon Dioxide Tension in Preterm and Term Infants

Wyatt, JS; Edwards, A. David; Cope, M; Delpy, DT; McCormick, David; Potter, A.; Reynolds, E. O. R.

doi:10.1203/00006450-199106010-00007

Cited by 220 publications

(116 citation statements)

References 24 publications

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“…25 Others have also observed in premature infants that PaCO 2 is an important regulator of CBF. [26][27][28] Acute changes in MABP may also affect CBF, especially if premature infants have impaired cerebral autoregulation. 29,33 In contrast to Perlman et al, 1 in our infant sample, MABP did not significantly influence mean CBFv, suggesting that cerebral autoregulation was probably intact in a majority of our sample group.…”

Section: Discussionmentioning

confidence: 99%

Tracheal suctioning is associated with prolonged disturbances of cerebral hemodynamics in very low birth weight infants

2007

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Objectives: Examining the effects of tracheal suctioning on cerebral hemodynamics of normotensive ventilated very low birth weight (VLBW) infants with normal cranial ultrasounds; determining the factor(s) influencing changes in mean cerebral blood flow velocity (CBFv) after suctioning.Methods: Seventy-three VLBW infants had continuous monitoring of mean arterial blood pressure (MABP), PaCO 2 , PaO 2 and mean CBFv before, during, and after 202 suctioning sessions during the first week of life. Peak (or nadir) and relative changes of the four variables for 45 min after suctioning were calculated. Multiple linear regression was used to determine the factor(s) influencing changes in mean CBFv after suctioning.Result: Birth weight was 928 ± 244 g; gestational age was 27.0 ± 2.0 weeks. Mean CBFv increased to 31.0 ± 26.4% after suctioning and remained elevated for 25 min. PaCO 2 was highly associated with mean CBFv (P<0.001), whereas MABP and PaO 2 were not. Conclusion:We observed prolonged increases of mean CBFv following suctioning in ventilated VLBW infants that were previously unrecognized. This is concerning since disturbances of CBF may be associated with subsequent brain injury.

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Section: Discussionmentioning

confidence: 99%

Tracheal suctioning is associated with prolonged disturbances of cerebral hemodynamics in very low birth weight infants

2007

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“…We It is now possible to obtain information noninvasively and continuously on cerebral hemodynamics and oxygenation using near infrared spectroscopy (NIRS) [1][2][3][4][5]. Nevertheless, there have been a few reports regarding effects of cerebral hemodynamics and oxygenation on ET [4].…”

Section: Discussionmentioning

confidence: 99%

“…The interoptode distance used in our study was 4.5 cm. We assumed an optical length of 4.4 times the interoptode distance in consideration of the scattering of light in brain tissue [3,5]. Transcutaneous carbon dioxide tension (TcPCO2, Micro Gas 7640, Kontron, Watford, England) and arterial oxygen saturation Cranial ultrasound scans were performed on all neonates using a 5 MHz probe at least twice before ET and numerous times after ET.…”

Section: Discussionmentioning

confidence: 99%

Changes of Cerebral Hemodynamics and Oxygenation in Unstable Septic Newborns during Exchange Transfusion.

et al. 1998

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“…This method has been used to measure the response of the cerebral circulation to changes in arterial carbon dioxide tension (Pryds et al 1990 ;Wyatt et al 1991). Discrepancies have been observed between the change in CBV calculated by this method and CBV derived by the indicator dilution technique (Brun et al 1994).…”

Section: Nirs Studies In Newborn Infantsmentioning

confidence: 99%

“…By viewing HbO # and Hb as endogenous intravascular tracer molecules it is possible to derive methods to obtain global cerebral blood flow (CBF), cerebral blood volume (CBV), its response to changing arterial carbon dioxide tension (CBVR) and mixed cerebral venous saturation (SvO # ) in the human newborn undergoing intensive care (Edwards et al 1988 ;Wyatt et al a, 1991Skov et al 1993 ;Yoxall et al 1995). In each case the method involves the establishment of a stable haemodynamic baseline, the induction of a small and quantitative physiological disturbance, the measurement of changes in [HbO # ] and [Hb] from the previously established baseline and the application of a standard formula.…”

Section: Principles Of Quantitative Spectroscopymentioning

confidence: 99%

Cerebral oxygenation and haemodynamics in the foetus and newborn infant

Wyatt

1997

Phil. Trans. R. Soc. Lond. B

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SUMMARYuantitative techniques have been derived for the measurement of global cerebral blood flow, cerebral blood volume, its response to changing arterial carbon dioxide tension and mixed cerebral venous saturation in the human newborn undergoing intensive care. Normal ranges have been established and significant disturbances of cerebral oxygenation and perfusion have been demonstrated in a variety of pathological conditions. Recently, absolute cerebral deoxyhaemoglobin concentration has been obtained in the newborn using second differential spectroscopy. When combined with the measurement of total cerebral haemoglobin concentration, the mean saturation of cerebral blood (SmcO # ) may be obtained, allowing global cerebral oxygenation to be determined continuously in the intensive care unit.Marked changes in the concentrations of cerebral oxy-and deoxyhaemoglobin have been observed in foetuses undergoing labour. Measurements of SmcO # from the foetal brain prior to delivery have shown the expected close correlation with acid-base status at birth. Although movement artefact remains a theoretical risk during uterine contractions, preliminary measurements of optical path length by intensitymodulated spectroscopy have demonstrated only small fluctuations. In future the clinical application of time, phase and spatially resolved spectroscopy is likely to improve both the quantitative accuracy and the regional specificity of physiological measurements in the foetal and neonatal brain.

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Response of Cerebral Blood Volume to Changes in Arterial Carbon Dioxide Tension in Preterm and Term Infants

Cited by 220 publications

References 24 publications

Tracheal suctioning is associated with prolonged disturbances of cerebral hemodynamics in very low birth weight infants

Tracheal suctioning is associated with prolonged disturbances of cerebral hemodynamics in very low birth weight infants

Changes of Cerebral Hemodynamics and Oxygenation in Unstable Septic Newborns during Exchange Transfusion.

Cerebral oxygenation and haemodynamics in the foetus and newborn infant

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