Mean arterial blood pressure changes in premature infants and those at risk for intraventricular hemorrhage

Henrietta S. Bada; Sheldon B. Korones; Edward H. Perry; Kristopher L. Arheart; John D. Ray; Massroor Pourcyrous; H. Lynn Magill; William Runyan; Grant W. Somes; Frank C. Clark; Katherine V. Tullis

doi:10.1016/S0022-3476(05)80700-0

Mean arterial blood pressure changes in premature infants and those at risk for intraventricular hemorrhage

Henrietta S. Bada
, Sheldon B. Korones
, Edward H. Perry
, Kristopher L. Arheart
, John D. Ray
, Massroor Pourcyrous
, H. Lynn Magill
, William Runyan
, Grant W. Somes
, Frank C. Clark
, Katherine V. Tullis

Producción científica: Article › revisión exhaustiva

271 Citas (Scopus)

Resumen

Bedside microcomputer-derived, minute-to-minute mean arterial pressure (MAP) values during the first 48 hours of life were studied in 100 preterm babies with birth weight ≤1500 gm. In those babies (n=72) with no periventricular-intraventricular hemorrhage (PV-IVH) or with grade 1 PV-IVH, the MAP values increased during the study period, with minute-to-minute variation and interval undulation. The MAP values in those with birth weight>1000 gm were higher than in those of lower birth weight. Infants in whom grades 2 to 4 PV-IVH developed (n=28) had consistently lower MAP values during the study period. Minute-to-minute variability, expressed as the average of the coefficients of variation at 15-minute intervals, did not differ between birth weight groups, nor did they differ between the PV-IVH group and their matched control subjects. However, those with PV-IVH spent a greater percentage of time, with a coefficient of variation≥13% or <3%, than their matched control subjects spent (p<0.005). This study provides reference data for MAP changes in premature babies. The observed MAP changes in those with PV-IVH lend support to a significant role for MAP alterations in the pathogenesis of PV-IVH.

Idioma original	English
Páginas (desde-hasta)	607-614
Número de páginas	8
Publicación	Journal of Pediatrics
Volumen	117
N.º	4
DOI	https://doi.org/10.1016/S0022-3476(05)80700-0
Estado	Published - oct 1990

Nota bibliográfica

Funding Information:
Studies in the human neonate suggest that ill infants have impaired autoregulation of cerebral blood flow. 1 With loss of autoregulation, cerebral blood flow becomes pressure passive (i.e., it increases when systemic blood pressure increases and decreases with decreasing BP). Aside from the changes in cerebral blood flow directly relating to BP changes, the arterial cerebral blood flow velocity pattern Supported by National Institutes of Health (National Institute of Neurological and Communicative Disorders and Stroke) Program Project grant No. NS-21405. Submitted for publication Feb. 7, 1990; accepted May 3, 1990. Reprint requests: Henrietta S. Bada, MD, Newborn Center, 853 Jefferson Ave., Room 201, Memphis, TN 38163. 9/23/22161 follows a pattern similar to the simultaneously obtained systemic arterial BP waveform. 2 Alterations in BP, by virtue of the effect on the cerebral circulation, have been implicated in the pathogenesis of neonatal periventricular hemorrhage. It was our hypothesis that babies at risk for PV-IVH have wide fluctuations in

Financiación

Studies in the human neonate suggest that ill infants have impaired autoregulation of cerebral blood flow. 1 With loss of autoregulation, cerebral blood flow becomes pressure passive (i.e., it increases when systemic blood pressure increases and decreases with decreasing BP). Aside from the changes in cerebral blood flow directly relating to BP changes, the arterial cerebral blood flow velocity pattern Supported by National Institutes of Health (National Institute of Neurological and Communicative Disorders and Stroke) Program Project grant No. NS-21405. Submitted for publication Feb. 7, 1990; accepted May 3, 1990. Reprint requests: Henrietta S. Bada, MD, Newborn Center, 853 Jefferson Ave., Room 201, Memphis, TN 38163. 9/23/22161 follows a pattern similar to the simultaneously obtained systemic arterial BP waveform. 2 Alterations in BP, by virtue of the effect on the cerebral circulation, have been implicated in the pathogenesis of neonatal periventricular hemorrhage. It was our hypothesis that babies at risk for PV-IVH have wide fluctuations in

Financiadores	Número del financiador
National Institutes of Health (NIH)
National Institute of Neurological Disorders and Stroke	P50NS021405

ASJC Scopus subject areas

Pediatrics, Perinatology, and Child Health

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10.1016/S0022-3476(05)80700-0

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@article{97481579429a42eb980071bfbfad728a,

title = "Mean arterial blood pressure changes in premature infants and those at risk for intraventricular hemorrhage",

abstract = "Bedside microcomputer-derived, minute-to-minute mean arterial pressure (MAP) values during the first 48 hours of life were studied in 100 preterm babies with birth weight ≤1500 gm. In those babies (n=72) with no periventricular-intraventricular hemorrhage (PV-IVH) or with grade 1 PV-IVH, the MAP values increased during the study period, with minute-to-minute variation and interval undulation. The MAP values in those with birth weight>1000 gm were higher than in those of lower birth weight. Infants in whom grades 2 to 4 PV-IVH developed (n=28) had consistently lower MAP values during the study period. Minute-to-minute variability, expressed as the average of the coefficients of variation at 15-minute intervals, did not differ between birth weight groups, nor did they differ between the PV-IVH group and their matched control subjects. However, those with PV-IVH spent a greater percentage of time, with a coefficient of variation≥13\% or <3\%, than their matched control subjects spent (p<0.005). This study provides reference data for MAP changes in premature babies. The observed MAP changes in those with PV-IVH lend support to a significant role for MAP alterations in the pathogenesis of PV-IVH.",

author = "Bada, \{Henrietta S.\} and Korones, \{Sheldon B.\} and Perry, \{Edward H.\} and Arheart, \{Kristopher L.\} and Ray, \{John D.\} and Massroor Pourcyrous and Magill, \{H. Lynn\} and William Runyan and Somes, \{Grant W.\} and Clark, \{Frank C.\} and Tullis, \{Katherine V.\}",

note = "Funding Information: Studies in the human neonate suggest that ill infants have impaired autoregulation of cerebral blood flow. 1 With loss of autoregulation, cerebral blood flow becomes pressure passive (i.e., it increases when systemic blood pressure increases and decreases with decreasing BP). Aside from the changes in cerebral blood flow directly relating to BP changes, the arterial cerebral blood flow velocity pattern Supported by National Institutes of Health (National Institute of Neurological and Communicative Disorders and Stroke) Program Project grant No. NS-21405. Submitted for publication Feb. 7, 1990; accepted May 3, 1990. Reprint requests: Henrietta S. Bada, MD, Newborn Center, 853 Jefferson Ave., Room 201, Memphis, TN 38163. 9/23/22161 follows a pattern similar to the simultaneously obtained systemic arterial BP waveform. 2 Alterations in BP, by virtue of the effect on the cerebral circulation, have been implicated in the pathogenesis of neonatal periventricular hemorrhage. It was our hypothesis that babies at risk for PV-IVH have wide fluctuations in",

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doi = "10.1016/S0022-3476(05)80700-0",

language = "English",

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AU - Bada, Henrietta S.

AU - Korones, Sheldon B.

AU - Perry, Edward H.

AU - Arheart, Kristopher L.

AU - Ray, John D.

AU - Pourcyrous, Massroor

AU - Magill, H. Lynn

AU - Runyan, William

AU - Somes, Grant W.

AU - Clark, Frank C.

AU - Tullis, Katherine V.

N1 - Funding Information: Studies in the human neonate suggest that ill infants have impaired autoregulation of cerebral blood flow. 1 With loss of autoregulation, cerebral blood flow becomes pressure passive (i.e., it increases when systemic blood pressure increases and decreases with decreasing BP). Aside from the changes in cerebral blood flow directly relating to BP changes, the arterial cerebral blood flow velocity pattern Supported by National Institutes of Health (National Institute of Neurological and Communicative Disorders and Stroke) Program Project grant No. NS-21405. Submitted for publication Feb. 7, 1990; accepted May 3, 1990. Reprint requests: Henrietta S. Bada, MD, Newborn Center, 853 Jefferson Ave., Room 201, Memphis, TN 38163. 9/23/22161 follows a pattern similar to the simultaneously obtained systemic arterial BP waveform. 2 Alterations in BP, by virtue of the effect on the cerebral circulation, have been implicated in the pathogenesis of neonatal periventricular hemorrhage. It was our hypothesis that babies at risk for PV-IVH have wide fluctuations in

PY - 1990/10

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N2 - Bedside microcomputer-derived, minute-to-minute mean arterial pressure (MAP) values during the first 48 hours of life were studied in 100 preterm babies with birth weight ≤1500 gm. In those babies (n=72) with no periventricular-intraventricular hemorrhage (PV-IVH) or with grade 1 PV-IVH, the MAP values increased during the study period, with minute-to-minute variation and interval undulation. The MAP values in those with birth weight>1000 gm were higher than in those of lower birth weight. Infants in whom grades 2 to 4 PV-IVH developed (n=28) had consistently lower MAP values during the study period. Minute-to-minute variability, expressed as the average of the coefficients of variation at 15-minute intervals, did not differ between birth weight groups, nor did they differ between the PV-IVH group and their matched control subjects. However, those with PV-IVH spent a greater percentage of time, with a coefficient of variation≥13% or <3%, than their matched control subjects spent (p<0.005). This study provides reference data for MAP changes in premature babies. The observed MAP changes in those with PV-IVH lend support to a significant role for MAP alterations in the pathogenesis of PV-IVH.

AB - Bedside microcomputer-derived, minute-to-minute mean arterial pressure (MAP) values during the first 48 hours of life were studied in 100 preterm babies with birth weight ≤1500 gm. In those babies (n=72) with no periventricular-intraventricular hemorrhage (PV-IVH) or with grade 1 PV-IVH, the MAP values increased during the study period, with minute-to-minute variation and interval undulation. The MAP values in those with birth weight>1000 gm were higher than in those of lower birth weight. Infants in whom grades 2 to 4 PV-IVH developed (n=28) had consistently lower MAP values during the study period. Minute-to-minute variability, expressed as the average of the coefficients of variation at 15-minute intervals, did not differ between birth weight groups, nor did they differ between the PV-IVH group and their matched control subjects. However, those with PV-IVH spent a greater percentage of time, with a coefficient of variation≥13% or <3%, than their matched control subjects spent (p<0.005). This study provides reference data for MAP changes in premature babies. The observed MAP changes in those with PV-IVH lend support to a significant role for MAP alterations in the pathogenesis of PV-IVH.

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Mean arterial blood pressure changes in premature infants and those at risk for intraventricular hemorrhage

Resumen

Nota bibliográfica

Financiación

ASJC Scopus subject areas

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