Background: The optimal upper and lower limits of blood pressure in preterm infants are not known. Exceeding these thresholds may contribute to intraventricular hemorrhage (IVH).
Methods: Preterm infants born ≤30 weeks GA were identified. Infants had continuous measurement of mean arterial blood pressure (MABP) for 7 days and cranial ultrasound imaging. IVH was classified as severe IVH (grade 3/4), no severe IVH (no IVH; grade 1/2), or no IVH. Mean ± SEM MABP values from hours 1-168 were calculated and sorted into bins 2 mm Hg wide. The normalized proportion of each recording spent in each bin was then calculated. Candidate limits were identified by comparison of MABP distribution in those with severe IVH vs. those without severe IVH.
Results: Eighty-five million measurements were made from 157 infants. Mean EGA was 25.2 weeks; mean BW was 749 g; 65/157 female; inotrope use in 59/157; grade 3/4 IVH in 29/157. Infants with severe IVH spent significantly more time with extreme MABP measurements (<23 mm Hg or >46 mm Hg) compared to those without severe IVH (12% vs. 8% of recording, p = 0.02).
Conclusions: Infants who developed severe IVH had substantially more unstable MABP and spent a significantly greater period of time with MABP outside of the optimal range.
Download full-text PDF |
Source |
|---|---|
| http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6962547 | PMC |
| http://dx.doi.org/10.1038/s41390-019-0585-3 | DOI Listing |
Publication Analysis
Top Keywords
Similar Publications
Risk factors for early periventricular intraventricular hemorrhage in extremely low birth weight infants: a retrospective study.
BMC Pediatr
January 2025
Department of Child Health, Guangzhou Women and Children's Medical Center, Guangzhou Medical University, 510623, Guangzhou, China.
Background: This study aimed to explore the risk factors for early intraventricular hemorrhage (IVH) in extremely low birth weight infants (ELBWIs) to provide guidance for early intervention, thereby improving survival rates and quality of life for these vulnerable infants.
Methods: A retrospective study was conducted on 205 ELBWIs admitted to the Women and Children's Medical Center of Guangzhou Medical University from January 2019 to December 2023. Standard head ultrasound screening (HUS) was used to assess the presence and severity of IVH on days 1-3 and 5-7 post-birth.
Comparative Efficacy of Ventriculosubgaleal Shunt Versus Ventricular Reservoir in Achieving Shunt Independence for Infants With Posthemorrhagic Hydrocephalus by 6 Months.
Neurosurgery
January 2025
Department of Neurosurgery, Ann & Robert H. Lurie Children's Hospital of Chicago, Chicago, Illinois, USA.
Background And Objectives: Low-birth weight, premature infants often have severe intraventricular hemorrhage (IVH), which can result in posthemorrhagic hydrocephalus (PHH), sometimes requiring cerebrospinal fluid diversion. Initial temporizing management of PHH includes placement of a ventriculosubgaleal shunt (VSGS) or ventricular access device (VAD). Studies have found similar permanent shunt conversion rates between VSGS and VAD but were limited by sample scope and size.
View Article and Find Full Text PDFOccurrence and Time of Onset of Intraventricular Hemorrhage in Preterm Neonates: A Systematic Review and Meta-Analysis of Individual Patient Data.
JAMA Pediatr
December 2024
Centre for Translational Medicine, Semmelweis University, Budapest, Hungary.
Importance: Intraventricular hemorrhage (IVH) has been described to typically occur during the early hours of life (HOL); however, the exact time of onset is still unknown.
Objective: To investigate the temporal distribution of IVH reported in very preterm neonates.
Data Sources: PubMed, Embase, Cochrane Library, and Web of Science were searched on May 9, 2024.
Intraventricular Hemorrhage and Survival, Multimorbidity, and Neurodevelopment.
JAMA Netw Open
January 2025
Population Policy and Practice, Great Ormond Street UCL Institute of Child Health, London, United Kingdom.
Importance: Intraventricular hemorrhage (IVH) has proven to be a challenging and enduring complication of prematurity. However, its association with neurodevelopment across the spectrum of IVH severity, independent of prematurity, and in the context of contemporary care remains uncertain.
Objective: To evaluate national trends in IVH diagnosis and the association with survival and neurodevelopmental outcomes at 2 years of age.
Neuroinflammatory pathways and potential therapeutic targets in neonatal post-hemorrhagic hydrocephalus.
Pediatr Res
December 2024
Department of Neurological Surgery, Ohio State University Medical Center, Columbus, OH, USA.
Background: Post-hemorrhagic hydrocephalus (PHH) is a severe complication in premature infants following intraventricular hemorrhage (IVH). It is characterized by abnormal cerebrospinal fluid (CSF) accumulation, disrupted CSF dynamics, and elevated intracranial pressure (ICP), leading to significant neurological impairments.
Objective: This review provides an overview of recent molecular insights into the pathophysiology of PHH and evaluates emerging therapeutic approaches aimed at addressing its underlying mechanisms.
Want AI Summaries of new PubMed Abstracts delivered to your In-box?
Enter search terms and have AI summaries delivered each week - change queries or unsubscribe any time!