CEREBRAL BLOOD-FLOW FLUCTUATION IN NEONATAL RESPIRATORY-DISTRESS AND PERIVENTRICULAR HEMORRHAGE

The relationship of cerebral blood flow fluctuation (CBFF) with perive ntricular haemorrhage (PVH) and respiratory distress syndrome (RDS) wa s studied in 35 preterm newborns. CBFF was defined as the interquartil e range in the ensemble of pulses of a 20-s Doppler recording of CBF v elocity (CBFV) in the internal carotid artery. We found a statisticall y significant increase in end diastolic CBFF in PVH and RDS. This incr ease was related to the mode of respiration (spontaneous or mechanical ly supported), the state of the ductus arteriosus, and the level of en d diastolic CBFV. Differences before and after the onset of PVH were n ot found. In view of this, we conclude that RDS increases CBFF, that t his increase is related to pleural pressure fluctuations, that these c an be damped by mechanical ventilation, and that their propagation to the CBF is promoted by patency of the ductus arteriosus and foramen ov ale. Whether the CBFF increase causes PVH, or is merely an expression of coincident RDS, remains a question that needs further investigation .