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Cerebral blood flow velocity variability in infants receiving assisted ventilation
J M Rennie1, M South, C J Morley
1University Department of Paediatrics, Addenbrooke's Hospital, Cambridge.
Archives of Disease in Childhood
|December 1, 1987
Summary
In premature infants on ventilators, breathing out of sync with the machine increases cerebral blood flow velocity variability. Synchronized breathing or apnea reduces this variability, crucial for brain development.
Area of Science:
- Neonatal physiology
- Cerebrovascular regulation
- Respiratory support
Background:
- Premature infants (<2500g) often require assisted ventilation.
- Cerebral blood flow (CBF) regulation is immature in neonates.
- Ventilator-respiratory synchrony is a concern in neonatal care.
Purpose of the Study:
- To investigate the impact of ventilator-respiratory synchrony on cerebral blood flow velocity (CBFV) variability in preterm infants.
- To quantify CBFV variability under different respiratory conditions: asynchronous breathing, synchronous breathing, and apnea.
Main Methods:
- Doppler ultrasonography was used to measure CBFV in 20 preterm infants on assisted ventilation.
- Spontaneous respiration patterns were recorded simultaneously.
- CBFV variability (coefficient of variation) was calculated from Doppler signals during asynchronous, synchronous, and apneic states.
Main Results:
- CBFV variability was highest within 12 hours of birth, decreasing over the subsequent 48 hours.
- Significantly greater CBFV variability occurred during asynchronous breathing (median 11%) compared to synchronous breathing (median 5%) or apnea (median 5%).
Conclusions:
- Asynchronous breathing with mechanical ventilation significantly increases CBFV variability in preterm infants.
- Optimizing ventilator-respiratory synchrony may be important for stabilizing cerebral hemodynamics in vulnerable neonates.
- Further research is needed to understand long-term implications of CBFV variability on neurodevelopment.