Development of cerebral blood flow volume in preterm neonates during the first two weeks of life
Development of cerebral blood flow volume in preterm neonates during the first two weeks of life
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DOI：
10.1203/01.pdr.0000182579.52820.c3
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发表时间：
2005-11-01
影响因子：
3.6
通讯作者：
Schöning, M
中科院分区：
文献类型：
--
作者：
Kehrer, M;Blumenstock, G;Schöning, M
为了研究出生后2周内大脑正常的早产儿脑灌注的发育，设计了一项前瞻性纵向研究。应用超声血流仪对32例胎龄28-35周的早产儿颅外供血动脉进行脑血流量（CBF）定量测定。于出生后第1、2、3、7、14天测量双侧颈内动脉和椎动脉。使用计算机超声系统（Acuson 128/XP 10）的10.0 MHz线性换能器。血管内流量计算为角度校正的时间平均流速和血管横截面积的乘积。平均CBF体积在前2周显著增加。这种上升的三分之一已经发生在出生后的第一天到第二天，此后有一个连续的增加，从第2天到第14天的生活。虽然CBF体积的绝对水平主要由经后年龄决定，但CBF体积的产后变化模式与胎龄无关。动脉二氧化碳分压、平均动脉血压和红细胞压积对CBF体积的发展没有影响。从第1天到第2天CBF体积的显著增加可能代表脑循环对出生后生活的正常适应性反应。这里提供的数据可以作为进一步研究的基础，以调查偏离这种适应性反应是否与脑损伤风险增加有关。
To investigate the postnatal development of cerebral perfusion in preterm neonates with normal brains over the first 2 wk of life, a prospective longitudinal study was designed. Quantitative measurement of cerebral blood flow (CBF) volume was performed using ultrasound flowmetry of the extracranial, brainfeeding arteries in 32 preterm infants of 28-35 wk gestational age. Measurements were done in the internal carotid and vertebral arteries of both sides on d 1, 2, 3, 7, and 14 after birth. A 10.0-MHz linear transducer of a computed sonography system (Acuson 128/XP10) was used. Intravascular flow volumes were calculated as the product of angle-corrected time-averaged flow velocity and the cross-sectional area of the vessel. Mean CBF volume increased markedly over the first 2 wk. One-third of this rise already occurred from the first to the second postnatal day, thereafter there was a continuous increase from d 2 to d 14 of life. Whereas the absolute level of CBF volume was primarily determined by postmenstrual age, the pattern of postnatal changes in CBF volume was found to be independent of gestational age. Arterial carbon dioxide tension, mean arterial blood pressure, and hematocrit had no influence on the development of CBF volume. The pronounced increase of CBF volume from d 1 to d 2 is likely to represent a normal adaptive response of the cerebral circulation to postnatal life. The data presented here may serve as the basis for further studies to investigate whether deviations from this adaptive response are associated with an increased risk of brain injury.