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Pediatr Res. 2016 Feb;79(2):333-8. doi: 10.1038/pr.2015.227. Epub 2015 Nov 5.

Fast Doppler as a novel bedside measure of cerebral perfusion in preterm infants.

Author information

1
Department of Pediatrics, University of Washington, Seattle, Washington.
2
Department of Neurological Surgery, University of Washington, Seattle, Washington.
3
Division of Engineering and Mathematics, University of Washington, Seattle, Washington.

Abstract

BACKGROUND:

Altered cerebral perfusion from impaired autoregulation may contribute to the morbidity and mortality associated with premature birth. We hypothesized that fast Doppler imaging could provide a reproducible bedside estimation of cerebral perfusion and autoregulation in preterm infants.

METHODS:

This is a prospective pilot study using fast Doppler ultrasound to assess blood flow velocity in the basal ganglia of 19 subjects born at 26-32 wk gestation. Intraclass correlation provided a measure of test-retest reliability, and linear regression of cerebral blood flow velocity and heart rate or blood pressure allowed for estimations of autoregulatory ability.

RESULTS:

The intraclass correlation when imaging in the first 48 h of life was 0.634. We found significant and independent correlations between the systolic blood flow velocity and both systolic blood pressure and heart rate (P = 0.015 and 0.012 respectively) only in the 26-28 wk gestational age infants in the first 48 h of life.

CONCLUSION:

Our results suggest that fast Doppler provides reliable bedside measurements of cerebral blood flow velocity at the tissue level in premature infants, acting as a proxy for cerebral tissue perfusion. Additionally, autoregulation appears to be impaired in the extremely preterm infants, even within a normal range of blood pressures.

PMID:
26539662
DOI:
10.1038/pr.2015.227
[Indexed for MEDLINE]

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