Vasoparalysis associated with brain damage in asphyxiated term infants

Journal Article · Sun Jul 01 00:00:00 EDT 1990 · Journal of Pediatrics; (USA)

DOI:https://doi.org/10.1016/S0022-3476(05)72459-8· OSTI ID:6873157

Pryds, O; Greisen, G; Lou, H; Friis-Hansen, B ^[1]

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1. Rigshospitalet, Copenhagen (Denmark)

The relationship of cerebral blood flow to acute changes in arterial carbon dioxide and mean arterial blood pressure (MABP) was determined during the first day of life in 19 severely asphyxiated term infants supported by mechanical ventilation. For comparison, 12 infants without perinatal asphyxia were also investigated. Global cerebral blood flow (CBF infinity) was determined by xenon 133 clearance two or three times within approximately 2 hours. During the cerebral blood flow measurement, the amplitude-integrated electroencephalogram and visual-evoked potential were recorded. Changes in arterial carbon dioxide pressure followed adjustments of the ventilator settings, whereas MABP fluctuated spontaneously. Arterial oxygen pressure and blood glucose concentration were in the normal range. Five of the asphyxiated infants had isoelectric electroencephalograms and died subsequently with severe brain damage. They had a high CBF infinity (mean 30.6 ml/100 gm/min) and abolished carbon dioxide and MABP reactivity. Lower CBF infinity (mean 14.7 ml/100 gm/min) and abolished MABP reactivity were found in another five asphyxiated infants with burst-suppression electroencephalograms in whom computed tomographic or clinical signs of brain lesions developed. The carbon dioxide reactivity was preserved in these infants. In the remaining nine asphyxiated infants without signs of central nervous system abnormality, carbon dioxide and MABP reactivity were preserved, as was also the case in the control group. We conclude that abolished autoregulation is associated with cerebral damage in asphyxiated infants and that the combination of isoelectric electroencephalograms and cerebral hyperperfusion is an early indicator of very severe brain damage.

• OSTI ID: 6873157
• Journal Information: Journal of Pediatrics; (USA), Vol. 117; ISSN 0022-3476
• Country of Publication: United States
• Language: English

Related Subjects

62 RADIOLOGY AND NUCLEAR MEDICINE
BRAIN
COMPUTERIZED TOMOGRAPHY
CEREBRAL CORTEX
BLOOD FLOW
NERVOUS SYSTEM DISEASES
DIAGNOSIS
BLOOD PRESSURE
CARBON DIOXIDE
CEREBROSPINAL FLUID
ELECTROENCEPHALOGRAPHY
INFANTS
XENON ISOTOPES
AGE GROUPS
BIOLOGICAL MATERIALS
BODY
BODY FLUIDS
CARBON COMPOUNDS
CARBON OXIDES
CENTRAL NERVOUS SYSTEM
CEREBRUM
CHALCOGENIDES
CHILDREN
DIAGNOSTIC TECHNIQUES
DISEASES
ISOTOPES
MATERIALS
NERVOUS SYSTEM
ORGANS
OXIDES
OXYGEN COMPOUNDS
TOMOGRAPHY
550601* - Medicine- Unsealed Radionuclides in Diagnostics