CEREBRAL BLOOD-FLOW VELOCITY AND PULSATION IN NEONATAL RESPIRATORY-DISTRESS SYNDROME AND PERIVENTRICULAR HEMORRHAGE

The present study addressed the hypotheses that cerebral ischemia and/ or excessive cerebral blood pulsation contribute to periventricular he morrhage in preterm newborns with respiratory distress and that the pu lse width is a valuable tool to estimate the contribution of cerebral blood pulsation. These hypotheses were tested by following preterm new borns at risk for respiratory distress and periventricular hemorrhage, We monitored for cerebral blood flow velocity (CBFV), cerebral pulse width, and cerebral pulsatility index; for patent ductus arteriosus, c apillary Pco(2), heart rate (HR) and behavior; and for the occurrence of respiratory distress and periventricular hemorrhage (PVH), The data obtained were analyzed with linear regression with the mode of respir ation (spontaneous or supported) and postnatal age as additional covar iates, We observed that (a) respiratory distress, either uncomplicated or complicated by PVH, correlates with a low CBFV and a high cerebral pulsatility index; (b) PVH also correlates with a high cerebral pulse width; (c) the increased pulse width precedes the onset of the hemorr hage; and (d) these CBF alterations can be partly attributed to ductal shunting and are ameliorated by mechanical ventilation. (C) 1997 by E lsevier Science Inc.