Low cerebral blood flow is a risk factor for severe intraventricular haemorrhage

Aims-To investigate the relation between cerebral blood flow on the first d ay of postnatal Life and the severity of any subsequent germinal matrix hae morrhage-intraventricular haemorrhage (GMH-IVH). Methods-Cerebral blood flow was measured in 24 babies during the first 24 h ours of life using near infrared spectroscopy. Repeated cerebral ultrasound examination was performed to define the maximum extent of GMH-IVH. Infants were classified as: normal scan, minor periventricular haemorrhage (haemor rhage that resolved), or severe GMH-IVH (haemorrhage distending the ventric les, that progressed to either post haemorrhagic dilatation or porencephali c cyst formation). Results-Cerebral blood flow was significantly lower in the infants with GMH -IVH (median 7.0 ml/100 g/min) than those without haemorrhage (median 12.2 ml/100 g/min), despite no difference in carbon dioxide tension and a higher mean arterial blood pressure. On subgroup analysis, those infants with sev ere GMH-IVH had the lowest cerebral blood flow. Conclusion-A low cerebral blood flow on the first day of life is associated with the subsequent development of severe intraventricular haemorrhage.