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Bradycardia and hypoxaemia due to position‐dependent hypoperfusion of the brain stem in a preterm infant
Author(s) -
Vogelberg C,
TautSack H,
Friebel D,
Maier U,
Rupprecht E
Publication year - 2004
Publication title -
acta pædiatrica
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.772
H-Index - 115
eISSN - 1651-2227
pISSN - 0803-5253
DOI - 10.1111/j.1651-2227.2004.tb00721.x
Subject(s) - medicine , supine position , bradycardia , anesthesia , cardiology , perfusion , heart rate , basilar artery , prone position , hypoxia (environmental) , blood pressure , oxygen , chemistry , organic chemistry
The case is reported of a male baby with a decreased time average velocity of the basilar artery to 32%, measured by Doppler sonography in dextro‐rotated head position. The decrease was due to a hypoplastic right vertebral artery with compression of the contralateral vertebral artery at the craniocervical junction during dextro‐rotation of the head. This finding was more prominent in prone than in supine position. A decrease in oxygen saturation and heart rate to >70% and 60bpm, respectively, was monitored during dextro‐rotation. The polysomnography also revealed postural‐dependent bradycardia, decrease of the oxygen saturation, and rising carbon dioxide partial tension in prone position with dextro‐rotation of the head. Conclusion : Hypoperfusion of the brain stem caused by postural changes leads to further clinically relevant changes. Therefore an association with an acute life‐threatening event and sudden infant death syndrome is speculated.