[en] Stable infants with anaemia needing a transfusion with adult red blood-cells were studied to elucidate changes in brain blood-flow velocity. Within 24 hours and at five to six days following transfusion a substantial mean flow velocity reduction was observed. Haemodynamic factors contributing to the reduction were an increase in cerebrovascular resistance and an increase in whole blood viscosity, as reflected by a raised pulsatility index. Transfusion with adult red blood-cells causes an elevation in haemoglobin concentration, thereby increasing the total oxygen-carrying capacity of arterial blood; however, this lowers the concentration of fetal haemoglobin which possesses a higher affinity for oxygen. Since cerebral oxygen transport is equal to the product of cerebral blood-flow and arterial oxygen content, this finding suggests the existence of a homeostatic mechanism for cerebral oxygen transport. The actual amount of cerebral oxygen transport was found to increase progressively as the percentage of fetal haemoglobin rose above 30 per cent. At higher fetal haemoglobin levels, appropriate elevations in cerebral blood-flow occurred, causing an increase in the supply of oxygen to the brain.
Disciplines :
Neurology Pediatrics
Author, co-author :
RAMAEKERS, Vincent ; Department of Paediatrics ; Katholieke Universiteit Leuven, Belgium
Casaer, P.; Professor of Paediatric Neurology, Department of Paediatrics Katholieke Universiteit Leuven, Belgium
Marchal, G.; Department of Radiology Katholieke Universiteit Leuven, Belgium
Smet, M.; Department of Radiology Katholieke Universiteit Leuven, Belgium
Goossens, W.; Department of Haematology Katholieke Universiteit Leuven, Belgium
Language :
English
Title :
The effect of blood transfusion on cerebral blood-flow in preterm infants: a Doppler study
Bergqvist G. (1974) Viscosity of the blood in the newborn infant. Acta Paediatrica Scandinavica 63:858-864.
Betke K., Marti H.R., Schlicht I. (1959) Estimation of small percentages of fetal haemoglobin. Nature 184:1877-1878.
Brown M.M., Marshall J. (1985) Regulation of cerebral blood‐flow in response to changes in blood viscosity. Lancet 1:604-609.
Wade J.P.H., Marshall J. (1985) Fundamental importance of arterial oxygen content in the regulation of cerebral blood flow. Brain 108:81-93.
Goslings R.G., King D.H. (1975) Ultrasound angiology. Arteries and Veins, Harcus, A. W., Adamson, L.,. Edinburgh:, Churchill Livingstone; .
Guyton A.C. (1971) Transport of oxygen and carbon dioxide in the blood and body fluids. Textbook of Medical Physiololgy, Guyton, A. C.,. Philadelphia:, W. B. Saunders; .
Humphrey P.R.D., Marshall J., Ross Russell R.W., Wetherley‐Mein G., Du Boulay G.H., Pearson T.C., Symon L., Zilkha E. (1979) Cerebral blood flow and viscosity in relative polycythaemia. Lancet 2:873-877.
Johansen K., Lenfant C. (1972) A comparativ: approach to the adaptability of O2‐Hb affinity. Oxygen Affinity of Haemoglobin and Red Cell Acid‐base Status, Rorth, M., Astrup, P.,. Copenhagen:, Munksgaard; .
Keitt A.S. (1971) Reduced nicotinamide adenine dinucleotide‐linked analysis of 2,3‐diphospho‐glyceric acid: spectrophotometric and fluoro‐metric procedures. Journal of Laboratory and Clinical Medicine 77:470-475.
Orzalesi M.M., Hay W.W. (1971) The regulation of oxygen affinity of fetal blood. I. In vitrq experiments and results in normal infants. Pediatrics 48:857-864.
Ramaekers V.Th., Casaer P. (1987) The influence of behavioural states on cerebral blood flow velocity patterns in preterm infants. Journal of Pediatrics 111:795.
Rosenkrantz T.S., Oh W. (1982) Cerebral blood flow velocity in infants with polycythemia and hyper viscosity: effects of partial exchange transfusion with plasmanate. Journal of Pediatrics 101:94-98.
Siegel S. Nonparametric Statistics for the Behavioral Sciences, New York:, McGraw‐Hill; 1956.
Thomas D.J., Du Boulay G.H., Marshall J., Pearson T.C., Ross, Wetherley‐Mein G., Symon L., Zilkha E. (1977) Cerebral blood flow in polycythaemia. Lancet 1:161-163.
Van Ameringen M.R., Fouron J.C., Bard H., Le Guennec J.C., Prosmanne J. (1981) Oxygenation in anemic newborn lambs with high or low oxygen affinity red cells. Pediatric Research 15:1500-1503.
Younkin D.P., Reivich M., Obrist W.D., Delivoria‐Papadopoulos M. (1981) Physiologic responses of neonatal rCBF. Journal of Cerebral Blood Flow and Metabolism, S213, 274; .