Tracheal suctioning is associated with prolonged disturbances of cerebral hemodynamics in very low birth weight infants
Tracheal suctioning is associated with prolonged disturbances of cerebral hemodynamics in very low birth weight infants
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DOI：
10.1038/sj.jp.7211848
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发表时间：
2008-01-01
影响因子：
2.9
通讯作者：
Williams, D. K.
中科院分区：
文献类型：
--
作者：
Kaiser, J. R.;Gauss, C. H.;Williams, D. K.
目的：检查气管吸痰对血压正常通气且头颅超声正常的极低出生体重儿（VLBW）脑血流动力学的影响;确定吸痰后影响平均脑血流速度（CBFv）变化的因素。研究方法：73名VLBW婴儿在出生后第一周内的202次吸痰前、吸痰中和吸痰后连续监测平均动脉血压（MABP）、PaCO 2、PaO 2和平均CBFV。计算吸痰后45 min四个变量的峰值（或最低点）和相对变化。使用多元线性回归确定影响抽吸后平均CBFv变化的因素。结果：出生体重为928 +/- 244 g;胎龄为27.0 +/- 2.0周。吸痰后平均CBFv增加至31.0 ± 26.4%，并持续升高25分钟。PaCO 2与平均CBFv高度相关（P < 0.001），而MABP和PaO 2则不相关。结论：我们观察到通气的VLBW婴儿吸痰后平均CBFv延长增加，这是以前未被认识到的。这是令人担忧的，因为CBF的紊乱可能与随后的脑损伤有关。
Objectives: Examining the effects of tracheal suctioning on cerebral hemodynamics of normotensive ventilated very low birth weight (VLBW) infants with normal cranial ultrasounds; determining the factor(s) influencing changes in mean cerebral blood flow velocity (CBFv) after suctioning. Methods: Seventy-three VLBW infants had continuous monitoring of mean arterial blood pressure (MABP), PaCO2, PaO2 and mean CBFv before, during, and after 202 suctioning sessions during the first week of life. Peak (or nadir) and relative changes of the four variables for 45 min after suctioning were calculated. Multiple linear regression was used to determine the factor(s) influencing changes in mean CBFv after suctioning. Result: Birth weight was 928 +/- 244 g; gestational age was 27.0 +/- 2.0 weeks. Mean CBFv increased to 31.0 +/- 26.4% after suctioning and remained elevated for 25 min. PaCO2 was highly associated with mean CBFv (P < 0.001), whereas MABP and PaO2 were not. Conclusion: We observed prolonged increases of mean CBFv following suctioning in ventilated VLBW infants that were previously unrecognized. This is concerning since disturbances of CBF may be associated with subsequent brain injury.