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Periventricular leukomalacia complex. Clinical and pathologic correlates.
Archives of Pathology & Laboratory Medicine
|February 1, 1982
Summary
Periventricular leukomalacia complex (PLC) in infants may be linked to hypotension, not hyperoxia. This finding challenges previous assumptions about oxygen toxicity in neonatal intensive care units.
Area of Science:
- Neonatalogy
- Pediatric Pathology
- Perinatal Medicine
Background:
- Periventricular leukomalacia complex (PLC) was previously associated with hyperoxia in neonatal intensive care units.
- A subsequent study indicated that periods of hyperoxia coincided with hypotension in affected infants.
Purpose of the Study:
- To re-evaluate the association between periventricular leukomalacia complex (PLC) and potential etiological factors in neonates.
- To investigate the relationship between PLC, hyperoxia, and hypotension using autopsy data.
Main Methods:
- Complete autopsies of 16 newborn subjects with PLC and 21 without PLC were reviewed.
- The incidence of bronchopulmonary dysplasia (BPD) and renal tubular necrosis was specifically examined in relation to PLC.
Main Results:
- The incidence of bronchopulmonary dysplasia (BPD) was similar in infants with and without PLC (44% vs 43%).
- Renal tubular necrosis, associated with hypotension, was observed in 3 infants with PLC but none without.
Conclusions:
- The findings suggest that periventricular leukomalacia complex (PLC) in neonates is more likely related to hypotension than to hyperoxia.
- This challenges the established view linking PLC to oxygen toxicity and highlights the role of hemodynamic instability.