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Intracranial pressure. Sequential measurements in full-term and preterm infants
American Journal of Diseases of Children (1960)
|June 1, 1981
Summary
Intracranial pressure (ICP) monitoring in newborns using a fiberoptic device revealed distinct patterns in full-term and preterm infants. Recent improvements in care for preterm infants appear to correlate with more stable ICP readings.
Area of Science:
- Neonatal Physiology
- Pediatric Neurology
Background:
- Intracranial pressure (ICP) is a critical indicator of neurological status in newborns.
- Accurate ICP monitoring is essential for timely intervention in at-risk infants.
Purpose of the Study:
- To sequentially measure and analyze intracranial pressure (ICP) in full-term and preterm infants during the first week of life.
- To investigate potential correlations between ICP values and clinical factors such as birth weight, gestational age, and respiratory support.
Main Methods:
- Utilized a pressure-activated fiberoptic device placed over the anterior fontanel for non-invasive ICP measurement.
- Monitored 120 full-term and 53 preterm infants during their first postnatal week.
- Recorded ICP values on specific days post-birth (Days 1-3 for full-term; Days 1-3, 5, 7 for preterm).
Main Results:
- Mean ICP in full-term infants was 12.6 cm H2O (Day 1), 12.1 cm H2O (Day 2), and 11.4 cm H2O (Day 3).
- Mean ICP in preterm infants varied: 10.2 cm H2O (Day 1), 17.0 cm H2O (Day 2), 11.0 cm H2O (Day 3), 8.9 cm H2O (Day 5), and 7.3 cm H2O (Day 7).
- Higher ICP values in preterm infants were associated with continuous positive airway pressure (CPAP) via nasal prongs; however, recent preterm infants show more stable ICP, possibly due to improved care, such as reduced hypoxemia.
Conclusions:
- ICP monitoring provides valuable insights into neonatal neurological status.
- ICP trends differ between full-term and preterm infants, with preterm infants exhibiting greater variability.
- Changes in clinical management, including respiratory support and reduction of hypoxemia, may positively influence ICP stability in preterm neonates.