Sebastian Gericke
Stellenbosch University and Tygerberg Children’s Hospital, South Africa
Title: Changes in cerebral blood flow and cardiac output in premature neonates in the first 72 hours of life
Biography
Biography: Sebastian Gericke
Abstract
Background: A major determinant of adverse neurodevelopmental outcome is the early acquisition of prematurity related brain injury associated with perturbations of cerebral hemodynamics. Several impediments however exist in establishing a causative relationship between systemic hemodynamic disturbances and prematurity related brain injury.
Methods: A nested cohort of a prospective cardiac output methods comparison in preterm infants was compiled and involved infants admitted to a tertiary level neonatal high care unit. An interim analysis of 63 premature infants meeting the inclusion criteria of gestational age between 26-34 weeks with recorded cranial ultrasound and echocardiographic data was performed. Excluded infants were those with birth weight <800 gm, gestational age <26 weeks, congenital defects and infants with asphyxia. Left Ventricular Cardiac Output (LVO), as measured by echocardiography was correlated to anterior cerebral artery flow velocities, derived from cranial ultrasound Doppler.
Results: Measurements were recorded at six hourly intervals up to 72 hours of life and analyzed in two subgroups: 31 infants (gestational age 28.6±1.25 weeks, range 26-30 weeks) and 32 infants (gestational age 32.4±1.0 weeks, range 30-34 weeks). LVO remained constant across gestational age categories. Peak-systolic flow velocity (PSV) and end-diastolic flow velocity (EDV) had initial low values with gradual increase over time. Lower mean values were detected in the 26-30-week gestational age group representing intrinsic differences in cerebral vasculature of the developing brain. Neither PSV nor EDV had a strong correlation with LVO.
Conclusion: In this population of relatively stable premature infants’ changes in PSV and EDV did not correlate with LVO suggesting intact cerebral autoregulation.