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Cerebral blood flow velocities and cerebrovascular resistance in normal‐term neonates in the first 72 hours
Author(s) -
Forster Danielle E,
Koumoundouros Emmanuel,
Saxton Virginia,
Fedai Gabrielle,
Holberton James
Publication year - 2018
Publication title -
journal of paediatrics and child health
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.631
H-Index - 76
eISSN - 1440-1754
pISSN - 1034-4810
DOI - 10.1111/jpc.13663
Subject(s) - medicine , middle cerebral artery , gestation , cardiology , diastole , cerebral arteries , cerebral blood flow , vascular resistance , hemodynamics , nuclear medicine , blood pressure , pregnancy , ischemia , biology , genetics
Aim To determine the range of cerebral blood flow velocities ( CBFVs ) and Doppler indices of cerebrovascular resistance in normal‐term neonates as a baseline for a study of hypoxic‐ischaemic encephalopathy. Methods The CBFV s, resistive index ( RI ) and pulsatility index ( PI ) were measured in the anterior and middle cerebral arteries ( ACA and MCA ) of 38 normal neonates. Results The mean peak systolic, end diastolic and time‐averaged velocities ( PSV , EDV and TAV ) were 36.3 ± 6.6, 12.4 ± 3.9 and 22.0 ± 4.0 cm/s ( ACA ) and 41.4 ± 13.2, 13.0 ± 5.5 and 25.8 ± 7.9 cm/s ( MCA ), respectively. All CBFV s in the ACA correlated with gestation; only EDV was correlated to post‐natal age. The RI in the ACA (0.67 ± 0.06) and MCA (0.68 ± 0.07) were correlated ( r = 0.72, P < 0.001); RI correlated to post‐natal age. Two infants with RI < 0.55 were both fed within 25 mins of the study; RI correlated with post‐prandial time (dichotomous, pivot 25 min). The mean PI was 1.11 ± 0.18 ( ACA ) and 1.17 ± 0.23 ( MCA ). Correlations were observed with post‐natal age and post‐prandial time (dichotomous). The average angle of insonation was greater in the ACA than in the MCA (median of 5° vs. 18°). Conclusions Results corresponded with previous published studies. No correlation was observed between Doppler indices and gestation as component velocities all increase with advancing gestation. Less variation and smaller standard deviation of CBFV's was associated with a smaller angle of insonation. Low RI s (<0.55), without a pathological cause, warrants further study.