Ikeda Toshifumi, Amizuka Takasuke, Ito Yuya, Mikami Ryosuke, Matsuo Koji, Kawamura Naoto, Fusagawa Shintaro
Department of Neonatology, Perinatal Center of Aomori Prefectural Central Hospital, 2-1-1, Higashitsukurimichi, Aomori-shi, Aomori, 030-8553, Japan,
Eur J Pediatr. 2015 Mar;174(3):331-8. doi: 10.1007/s00431-014-2396-1. Epub 2014 Aug 30.
This prospective observational study aimed to investigate the association between changes in the Doppler perfusion waveform of the internal cerebral vein and risk of intraventricular hemorrhage (IVH) in extremely low-birth-weight (ELBW) infants. We evaluated the perfusion waveform of the internal cerebral vein every 8 h from immediately after birth to 144 h post-birth in 80 ELBW infants (<1,000 g) in our hospital. Fluctuations in the measured perfusion waveform were categorized into four patterns according to their increasing magnitude, from grade 0 (steady flow waveform) to grade 3; the IVH rate was investigated. Infants with grades 0-1 fluctuations of the perfusion waveform were classified as low grade (n = 55), and those with grades 2-3 fluctuations were classified as high grade (n = 25). The IVH rate was significantly higher in the high-grade group than the low-grade group (28 vs. 1%, p < 0.001). The IVH group (n = 8) showed a significantly greater rate of high-grade perfusion waveform than the non-IVH group (n = 72) (87 vs. 25%, p < 0.001).
Changes in the perfusion waveform of the internal cerebral vein during the acute management of ELBW infants may be associated with IVH.
这项前瞻性观察性研究旨在调查极低出生体重(ELBW)婴儿大脑内静脉多普勒灌注波形变化与脑室内出血(IVH)风险之间的关联。我们对我院80例ELBW婴儿(<1000克)从出生后即刻至出生后144小时每8小时评估一次大脑内静脉的灌注波形。根据测量的灌注波形波动幅度增加情况将其分为四种模式,从0级(稳定血流波形)到3级;调查IVH发生率。灌注波形波动为0 - 1级的婴儿被归类为低级别组(n = 55),波动为2 - 3级的婴儿被归类为高级别组(n = 25)。高级别组的IVH发生率显著高于低级别组(28%对1%,p < 0.001)。IVH组(n = 8)的高级别灌注波形发生率显著高于非IVH组(n = 72)(87%对25%,p < 0.001)。
ELBW婴儿急性管理期间大脑内静脉灌注波形变化可能与IVH有关。