Factors affecting cerebrovascular reactivity to CO2 in premature infants
-
Safwat Aly
,
Zhigang Lu
Abstract
Background
Hypercarbia increases cerebral blood flow secondary to cerebral vasodilatation, while hypocarbia can lead to vasoconstriction with a subsequent decrease in cerebral blood flow. The aim of this study was to examine CO2 cerebral vasoreactivity in a cohort of premature infants and to identify factors which influence this reactivity.
Methods
We prospectively studied a cohort of hemodynamically stable premature infants [birth weight (BW) <1500 g and gestational age (GA) ≤34 weeks]. Subjects underwent two studies, one in the first 72 h and the second after 1 week of life. Infants were continuously monitored via a physiology station that included transcutaneous CO2 (tcPCO2) monitor, near-infrared spectroscopy (NIRS), arterial pulse oximetry and heart rate. The total hemoglobin (Hb-T) signal of NIRS was used as an indicator of cerebral blood volume (CBV). Correlation between tcPCO2 and Hb-T was performed in each 1-h period using Pearson’s correlation. Factors affecting the CO2 cerebrovascular reactivity were examined using bivariate and linear regression analyses.
Results
A total of 3847 1-h epochs were obtained from 140 studies of 72 premature infants. tcPCO2 correlated positively with Hb-T in 42% of epochs. In regression analysis, factors associated with increased percentage of positive correlation epochs were male sex and younger postmenstrual age (PMA; β = 0.176, 0.169 and P-value = 0.036, 0.047 respectively). Factors associated with increased strength of positive correlation were mechanical ventilation and increased average tcPCO2 (β = 0.198, 0.220 and P-value = 0.024, 0.011 respectively).
Conclusion
Increased prematurity, male sex, mechanical ventilation and hypercarbia are associated with stronger PCO2 cerebrovascular reactivity in premature infants. This association may explain their role in the pathogenesis of brain injury.
Author contributions: All the authors have accepted responsibility for the entire content of this submitted manuscript and approved submission.
Research funding: None declared.
Employment or leadership: None declared.
Honorarium: None declared.
Competing interests: The funding organization(s) played no role in the study design; in the collection, analysis, and interpretation of data; in the writing of the report; or in the decision to submit the report for publication.
Declaration: The authors have no financial interest and no funding source to disclose.
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©2019 Walter de Gruyter GmbH, Berlin/Boston
Articles in the same Issue
- Frontmatter
- Corner of Academy
- Multi-center results on the clinical use of KANET
- The use of atosiban prolongs pregnancy in patients treated with fetoscopic endotracheal occlusion (FETO)
- Original Articles – Obstetrics
- Evidence that intra-amniotic infections are often the result of an ascending invasion – a molecular microbiological study
- Advanced technology in obstetric education: a high-fidelity simulator for operative vaginal delivery
- Fetal adrenal gland size in gestational diabetes mellitus
- Characteristics of obstetric admissions to intensive care unit: APACHE II, SOFA and the Glasgow Coma Scale
- An investigation of vitamin and mineral supplement recommendation among first-trimester pregnancies
- Original Articles – Fetus
- Twin fetal facial expressions at 30–33+6 weeks of gestation
- Measurement of inferior facial angle and prefrontal space ratio in first trimester fetuses with aneuploidies: a retrospective study
- Original Articles – Newborns
- Factors affecting cerebrovascular reactivity to CO2 in premature infants
- Subcutaneous fat necrosis, a rare but serious side effect of hypoxic-ischemic encephalopathy and whole-body hypothermia
- Point-of-care ultrasound for peripherally inserted central catheter monitoring: a pilot study
- Acknowledgment
Articles in the same Issue
- Frontmatter
- Corner of Academy
- Multi-center results on the clinical use of KANET
- The use of atosiban prolongs pregnancy in patients treated with fetoscopic endotracheal occlusion (FETO)
- Original Articles – Obstetrics
- Evidence that intra-amniotic infections are often the result of an ascending invasion – a molecular microbiological study
- Advanced technology in obstetric education: a high-fidelity simulator for operative vaginal delivery
- Fetal adrenal gland size in gestational diabetes mellitus
- Characteristics of obstetric admissions to intensive care unit: APACHE II, SOFA and the Glasgow Coma Scale
- An investigation of vitamin and mineral supplement recommendation among first-trimester pregnancies
- Original Articles – Fetus
- Twin fetal facial expressions at 30–33+6 weeks of gestation
- Measurement of inferior facial angle and prefrontal space ratio in first trimester fetuses with aneuploidies: a retrospective study
- Original Articles – Newborns
- Factors affecting cerebrovascular reactivity to CO2 in premature infants
- Subcutaneous fat necrosis, a rare but serious side effect of hypoxic-ischemic encephalopathy and whole-body hypothermia
- Point-of-care ultrasound for peripherally inserted central catheter monitoring: a pilot study
- Acknowledgment
