Affiliation:
1. Kyoto Prefectural University of Medicine
2. Japanese Red Cross Kyoto Daiichi Hospital
3. National Hospital Organization Maizuru Medical Center
Abstract
Abstract
Purpose
It is important to monitor cerebral perfusion in infants because hypo- and hyperperfusion can contribute to neurological injury. This study aimed to clarify the relationship between trans-systolic time (TST) and critical closing pressure (CrCP) or estimated cerebral perfusion pressure (CPPe) in neonates. Moreover, we aimed to determine the TST values in preterm and term infants with stable cerebral perfusion to clarify normative reference data.
Methods
This multicentre prospective study included infants with arterial lines admitted to the neonatal intensive care units between December 2021 and August 2023. TST, CrCP, and CPPe were calculated using middle cerebral artery waveforms recorded using transcranial Doppler ultrasonography when clinicians collected arterial blood samples.
Results
Three hundred and sixty samples were obtained from 112 infants with a gestational age of 32 (interquartile range, 27–37) weeks and a birth weight of 1481 (956–2355) g. TST was positively correlated with CPPe (r = 0.60, p < 0.001), but not with CrCP (r = 0.08, p = 0.10). The normative reference values of TST in preterm and term infants without samples of hyper- or hypocapnia and/or hyper- or hypotension, which may affect cerebral perfusion, were as follows: ≤ 29 weeks, 0.12 (0.11–0.14) s; 30–36 weeks, 0.14 (0.12–0.15) s; and ≥ 37 weeks, 0.16 (0.14–0.17) s, respectively.
Conclusions
TST in neonates significantly correlated with CPPe, but not with CrCP. This parameter may be a good predictor of cerebral perfusion and potentially have wider clinical applications.
Publisher
Research Square Platform LLC