[en] Prior to and 24 h following blood transfusion serial determinations of both cerebral artery flow velocity waveforms and mean arterial blood pressure have been used to reconstruct the autoregulatory curve and its upper blood pressure limit among five stable preterm infants. Prior to transfusion the autoregulatory range of cerebral blood flow (CBF) was narrow due to a relatively low-set upper blood pressure limit. At 24 h after transfusion each individual has been re-examined. Following correction of anemia both a significant reduction of CBF velocities as well as a concomitant rise of the Pulsatility Index (PI) occurred over the entire range of blood pressures indicating a reduction of CBF after transfusion. In addition a right-sided shift of the upper limit towards higher mean blood pressures occurred after transfusion and resulted in an extension of the autoregulatory plateau of CBF. These favourable effects of blood transfusion ameliorating autoregulation of brain blood flow particularly at higher blood pressures might well bear important therapeutic perspectives in our effort to prevent intracranial haemorrhage among sick preterm infants.
Disciplines :
Neurology Pediatrics
Author, co-author :
RAMAEKERS, Vincent ; Developmental Neurology Research Unit, Department of Paediatrics, Neonatal Medicine University Hospital Gasthuisberg, Belgium
Casaer, P.; Developmental Neurology Research Unit, Department of Paediatrics, Neonatal Medicine University Hospital Gasthuisberg, Belgium
Daniels, H.; Developmental Neurology Research Unit, Department of Paediatrics, Neonatal Medicine University Hospital Gasthuisberg, Belgium
Marchal, G.; Department of Radiology, University Hospital Gasthuisberg, Katholieke Universiteit Leuven, Belgium
Language :
English
Title :
The influence of blood transfusion on brain blood flow autoregulation among stable preterm infants.
Brown, Wade, Marshall (1985) Fundamental importance of arterial oxygen content in the regulation of cerebral blood flow. Brain 108:81-93.
Casaer, Devlieger, Willekens (1980) Recording of upper and lower thoracic and abdominal respiratory movements in preterm neonates. Acta Paediatr. Belg. 33:253-260.
Goslings, King (1975) Ultrasound angiology. Arteries and Veins, A.W. Harcus, L. Adamson, Churchill Livingstone, Edinburgh; .
Greisen, Johansen, Ellison (1984) Cerebral blood flow in the newborn infant. Comparison of Doppler ultrasound and 133 xenon clearance , J. Pediatr.; 104:411-418.
Hansen, Stonestreet, Rosenkrantz (1983) Validity of Doppler measurements of anterior cerebral artery blood flow velocity: correlation with brain blood flow in piglets. Pediatrics 72:526-531.
Ramaekers, Casaer, Daniels, Smet, Devlieger, Marchal (1987) Variability in cerebral blood flow and the upper limit of cerebral blood flow autoregulation in preterm infants. Neuropediatrics 18:121.
Ramaekers, Casaer, Marchal, Smet, Goossens (1988) The effect of blood transfusion on cerebral blood flow in preterm infants: a Doppler study. Dev. Med. Child Neurol. 30:334-341.
Ramaekers, Casaer, Daniels, Smet, Marchal (1989) The influence of behavioural states on cerebral blood flow velocity patterns in stable preterm infants. Early Hum. Dev. 20:229-246.
Ramaekers, Casaer, Daniels (1990) Upper limits of brain blood flow autoregulation in stable infants of various conceptional age. Early Hum. Dev. 24:249-258.
Siegel Nonparametric Statistics for the Behavioral Sciences, McGraw-Hill, New York; 1956.
Strandgaard, Olesen, Skinhoj, Lassen (1973) Autoregulation of brain circulation in severe arterial hypertension. BMJ 159:507-510.
Volpe (1987) Specialized studies in the neurological evaluation. Neurology of the Newborn, J. Volpe, W.B. Saunders; .
Younkin, Reivich, Obrist, Delivoria-Papadopoulos (1981) Physiologic responses of neonatal rCBF. J. Cereb. Blood Flow Metab. , Suppl.; 1:S273-S274.