Alterations in Cerebral Blood Flow Velocities in Newborns with Birth Asphyxia
Adrian I. Toma. Neonatology, Panait Sarbu Obstetrics and Gynecology Hospital, Bucharest, Romania.
BACKGROUND: During the evolution of the cases of birth asphyxia, important modifications of the cerebral blood flow are likely to occur.
OBJECTIVE: The aim of the study was to investigate the evolution of the cerebral blood flow (CBF) velocities and resitivity index (RI) in the neonates with severe birth asphyxia compared to the normal newborns
DESIGN/METHODS: The control sample was formed of 50 normal term newborns (mean BW =3540 ± 250 g, mean GA 39 weeks), born between January 1 2003 - December 1 2004, in Panait Sarbu Maternity Hospital Bucharest . This sample was compared with 18 neonates with severe perinatal asphyxia, Sarnat 3 (mean BW = 3620g ± 238 g), born in our hospital in the same period of time. In each case, there were performed cerebral Doppler ultrasounds, 2 ultrasounds per day in the first 3 days of life. There were measured in each case the peak systolic velocity (PSV), end diastolic velocity (EDV) and the RI at the level of the anterior cerebral artery (ACA). The values in the normal neonates were then compared with the values in the newborns with severe birth asphyxia. The statistical method used wer: the Independent sample T test and the Paired Samples T.
RESULTS: The evolution of the CBF velocities in the case of normal newborns was as follows: PSV (day 1=38.35 ± 4.19 cm/s, day2=32.68 ± 4.56 cm/s,, day 3=32.92 ±5.27 cm/s,), EDV (day 1=8.47 ± 1.12cm/s, , day2=10.42 ± 1.4 cm/s, , day 3=11.53 ± 2.29 cm/s,), RI (day 1=0.76 ± 0.016, day2=0.68 ± 0.018, day 3 =0.65 ±0.035). In the case of the neonates with birth asphyxia the values noted in the first three days of life were: PSV (day 1=35.2 ± 4.04 cm/s, day2=32.0 ± 2.54 cm/s,, day 3=32.11 ± 3.80 cm/s,), EDV (day 1=7.82 ± 1.81cm/s, , day2=13.48 ± 1.14 cm/s, , day 3=15.03 ± 1.82 cm/s,), RI (day 1=0.75 ± 0.024, day2=0.58 ± 0.016, day 3=0.53 ±0.015). There was noted in the birth asphyxia group a statistically significant decrease in the RI from day 1 to day 3 (p< 0.0001). This dercrease was due to a statistically significant increase in the EDV between birth and day 3 of life (p< 0.0001). There was also noted a statistically significant difference between the EDV (p< 0.0002 ) and the RI (p< 0.0001 ) in the two groups in the day 3 of life.
CONCLUSIONS: In the case of severe birth asphyxia there can be seen a significant decrease in the RI and an increase of the EDV that could be related to the reperfusion injury.
PAS 2005: 57: 2417
Tuesday, May 17, 2005 12:15 pm, Washington Convention Center - Room 207 A
Platform Session: Global Perspectives on Birth Asphyxia, Part II (10:30 AM - 12:30 PM)
Course Number: 7350