ISSN:
1432-1076
Keywords:
Cerebral blood flow velocity
;
Ductus arteriosus ligation
;
Preterm neonate
Source:
Springer Online Journal Archives 1860-2000
Topics:
Medicine
Notes:
Abstract Intraoperative Doppler sonographic examinations were carried out on seven preterm neonates to measure cerebral blood flow velocity changes in the anterior cerebral arteries during ductus arteriosus ligation. Age at surgery was 12±6 days. Continuous recordings during the operative procedure showed a rapid increase in diastolic blood pressure (P〈0.01), whereas systolic blood pressure was not significantly higher compared with pre-occlusion values. In the anterior cerebral arteries, ductal closure led to a decrease in resistance index of Pourcelot (mean=1.02±0.08 vs 0.65±0.07 (P〈0.001)) and to an increase in area under the velocity curve (mean=3.64±0.38 vs 8.16±1.07 (P〈0.001)). These changes were associated with a corresponding increase of the end diastolic flow velocity (P〈0.001) but no change in the peak systolic velocity. The heart rate did not change significantly during ductal closure. TcPO2, TcPCO2 remained normal during the study period. These data indicate that changes in cerebral blood flow velocity during surgical ligation are principally determined by changes in systemic diastolic pressure. Systolic blood pressure and peak systolic flow velocity remain unchanged or slightly higher than preligation values, thereby restoring normal cerebral blood flow velocity pattern without increasing the stress on the wall of cerebral vessels and thus the risk of peri-intraventricular haemorrhage.
Type of Medium:
Electronic Resource
URL:
http://dx.doi.org/10.1007/BF01955941
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