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Non-invasive Optical Measurement of Cerebral Metabolism and Hemodynamics in Infants
11:39

Non-invasive Optical Measurement of Cerebral Metabolism and Hemodynamics in Infants

Published on: March 14, 2013

Cerebral oxygenation is highly sensitive to blood pressure variability in sick preterm infants

Flora Y Wong1, Reshma Silas, Simon Hew

  • 1The Ritchie Centre, Monash University, Melbourne, Victoria, Australia. Flora.Wong@monash.edu

Plos One
|August 21, 2012
PubMed

Insights

Increased blood pressure variability (BPV) is linked to cerebral oxygenation fluctuations in preterm infants. Critically ill infants show impaired autoregulation, making them vulnerable to brain injury from blood pressure changes.

Area of Science:

  • Neonatal physiology
  • Cerebral autoregulation
  • Neonatal intensive care

Background:

  • Blood pressure variability (BPV) significance for cerebral oxygenation in preterm infants is understudied.
  • BPV may be associated with end-organ injury in this population.
  • Cerebral autoregulation aims to maintain stable cerebral blood flow despite blood pressure changes.

Purpose of the Study:

  • To investigate the association between BPV and cerebral oxygenation in preterm infants.
  • To assess cerebral autoregulatory capacity by correlating BPV with cerebral oxygenation.
  • To determine if increased BPV exceeds autoregulation, leading to oxygenation changes.

Main Methods:

  • Studied 32 preterm infants (mean gestational age 26.3 weeks) over the first 3 postnatal days.
  • Used spectral analysis to calculate coherence between mean arterial blood pressure (MABP) and tissue oxygenation index (TOI).
  • Quantified BPV using power spectral density of MABP.

Main Results:

  • A trend for positive correlation between maximum coherence and BPV was observed (p=0.06).
  • Critically ill infants (n=7) with brain injury showed high coherence at low BPV, indicating impaired autoregulation.
  • Stable infants (n=25) demonstrated a significant association between maximum coherence and BPV (p=0.006).

Conclusions:

  • Cerebral oxygenation fluctuations are closely associated with increased BPV in preterm infants in intensive care.
  • Critically ill preterm infants exhibit blood pressure-dependent cerebral oxygenation changes even with lower BPV, suggesting severely impaired autoregulation.
  • These findings highlight the vulnerability of critically sick preterm infants to cerebral injury due to blood pressure fluctuations.
Abstract

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