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Longitudinal Change of Cerebral Blood Flow Velocity in Neonates with Perinatal Asphyxia and Hypoxic-Ischemic Encephalopathy with Doppler Technique

Journal of the Korean Pediatric Society 1994;37(9):1196-1204.
Published online September 15, 1994.
Longitudinal Change of Cerebral Blood Flow Velocity in Neonates with Perinatal Asphyxia and Hypoxic-Ischemic Encephalopathy with Doppler Technique
Kook In Park, Dong Kwan Han, Joon Soo Lee, Ran Namgung, Chul Lee
Department of Pediatrics, Yonsei University, College of Medicine, Seoul, Korea
주산기 가사 및 저산소성 허혈성 뇌증이 있는 신생아에서 도플러를 이용한 뇌혈류속도의 종적 변동에 관한 연구
박국인, 한동관, 이준수, 남궁란, 이철
연세대학교 의과대학 소아과학교실
Abstract
Fifty-three full-term, preterm, term-SGA newborn infants with perinatal asphyxia and 16 full-term infants with hypoxic-ischemic encephalopathy were studied with color Doppler songraphy to assess the postnatal change of the cerebral blood flow velocity(CBFV) longitudinally. A control group of 81 healthy infants also had CBFV recordings during the 1st week of life. Pourcelot Resistance index(PI) and area under the velocity curve(AUVC) were calculated to quantitate changes in CBFV. PI values of full-term infants with perinatal asphyxia were within normal range, but AUVC values were higher on day 1 and 7 than those of normal full-term infants. In preterm and full-term SGA infants with perinatal asphyxia, PI and AUVC values were also within normal range during the 1st week of life. Full-term and preterm infants with perinatal asphyxia showed no significant difference in PI and AUVC values according to the degree of asphyxia. The full-term infants with hypoxic-ischemic encephalopathy showed significant decreased PI and increased AUVC values from the 2nd day of life compared with those of normal and asphyxiated infants reflecting high cerebral blood flow state. We also found a relationship between disturbances of consciousness and the PI. The prediction of occurrence of hypoxic-ischemic encephalopathy by abnormal Doppler studies(PI≤0.55) showed a sensitivity of 100% and a specificity of 88%.
Key Words: Pulsatility index(PI), Area under the velocity curve(AUVC), Cerebral blood flow velocity(CBFV), Perinatal asphyxia, Hypoxic-ischemic encephalopathy, Newborn infant


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