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与新生儿脑室内出血相关的临床事件

Clinical events relating to intraventricular haemorrhage in the newborn.

作者信息

Fujimura M, Salisbury D M, Robinson R O, Howat P, Emerson P M, Keeling J W, Tizard J P

出版信息

Arch Dis Child. 1979 Jun;54(6):409-14. doi: 10.1136/adc.54.6.409.

Abstract

Continuous measurements of arterial pressures, heart rates, respiratory movements, and respiratory rates were made from birth in 44 infants at risk from intraventricular haemorrhage (IVH). 17 babies died with IVH, in 10 of whom the event was timed objectively. Events in these babies were compared with survivors of similar birthweights, gestational ages, severity of birth asphyxia, and severity of hyaline membrane disease (HMD). IVH followed severe HMD and was associated with cessation of the babies' own respiratory efforts while on a ventilator and also with characteristic cardiorespiratory events. The minimum arterial pressure before IVH was lower than in comparable babies who survived. It is suggested that fluctuations of systemic blood pressure from initial low levels may be important in the pathogenesis of IVH. It is possible that changes in cerebral blood flow are of even greater significance.

摘要

对44名有脑室内出血(IVH)风险的婴儿从出生起就持续测量动脉血压、心率、呼吸运动和呼吸频率。17名婴儿死于IVH,其中10例事件有客观的时间记录。将这些婴儿的情况与出生体重、胎龄、出生窒息严重程度和透明膜病(HMD)严重程度相似的存活婴儿进行比较。IVH发生在严重HMD之后,与婴儿在使用呼吸机时自身呼吸努力的停止以及特征性心肺事件有关。IVH发生前的最低动脉血压低于存活的对照婴儿。提示全身血压从初始低水平的波动可能在IVH的发病机制中起重要作用。脑血流的变化可能具有更重要的意义。

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本文引用的文献

1
Subependymal cerebral hemorrhage in premature infants, and its relation to various injurious influences at birth.
Am J Obstet Gynecol. 1951 Jun;61(6):1285-92. doi: 10.1016/0002-9378(51)90913-1.
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Subependymal cerebral hemorrhage in infancy.
Am J Dis Child. 1965 Nov;110(5):531-42. doi: 10.1001/archpedi.1965.02090030555007.
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Intracranial haemorrhage associated with hyaline membrane disease.与透明膜病相关的颅内出血
Arch Dis Child. 1968 Feb;43(227):116-20. doi: 10.1136/adc.43.227.116.
9
Hypernatremia and intracranial hemorrhage in neonates.
N Engl J Med. 1974 Jul 4;291(1):6-10. doi: 10.1056/NEJM197407042910102.

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