Pediatric research 2017 05 29() doi 10.1038/pr.2017.131
Post-hemorrhagic ventricular dilatation (PHVD) is predictive of mortality and morbidity among very low birth-weight preterm infants. Impaired cerebral blood flow (CBF) due to elevated intracranial pressure (ICP) is believed to be a contributing factor.
A hyperspectral near-infrared spectroscopy (NIRS) method of measuring CBF and the cerebral metabolic rate of oxygen (CMRO2) was used to investigate perfusion and metabolism changes in patients receiving a ventricular tap (VT) based on clinical management. To improve measurement accuracy, the spectral analysis was modified to account for compression of the cortical mantle caused by PHVD and the possible presence of blood breakdown products.
From 9 patients (27 VTs), a significant CBF increase was measured (15.6%) following VT (14.6±4.2 to 16.9±6.6 ml/100 g/min), but with no corresponding change in CMRO2 (1.02±0.41 ml O2/100 g/min). Post-VT CBF was in good agreement with a control group of 13 patients with patent ductus arteriosus but no major cerebral pathology (16.5±7.7 ml/100 g/min), while tissue oxygen saturation (StO2) was significantly lower (58.9±12.1 vs. 70.5±9.1% for controls).
CBF was impeded in PHVD infants requiring a clinical intervention, but the effect is not large enough to alter CMRO2.Pediatric Research accepted article preview online, 29 May 2017. doi:10.1038/pr.2017.131.