Cerebral perfusion pressure in the high-risk premature infant.

Continuous monitoring of the cerebral perfusion pressure (CPP) and arterial blood gases was performed in 13 high-risk preterm infants. CPPs were monitored with a Ladd fiberoptic transducer. Blood gases were measured via umbilical artery lines. Monitoring was performed within 12 h following birth and continued for 48-72 h. The mean gestational age (+/- SD) was 30.6 +/- 3.1 weeks with a mean weight (+/- SD) of 1,326 +/- 511 g. Initial mean CPP (+/- SD) was 37.3 +/- 8.9 mm Hg with a mean initial intracranial pressure (ICP) of 2.7 +/- 1.8 mm Hg. During the trial period, a sustained CPP below 25 mm Hg for over 2 h was indicative of a poor neurological outcome. A sustained ICP over 7 mm Hg was indicative of intracranial hypertension, but occurred in relation to nursing events such as suctioning or positioning of the patient's head. Seven infants demonstrated significant linear relationships between CPP or ICP and levels of arterial pCO2 or pH. The mean Apgar scores were significantly higher for this group, but the presence of this relationship did not indicate a better neurological outcome.