Abstract
It is generally assumed that one reason why white matter injury is common in preterm infants is the relatively poor vascular supply. Aim: To examine whether blood flow to the white matter is relatively more reduced at low blood pressure than is blood flow to the brain as a whole. Methods: Thirteen normoxic preterm infants had blood flow imaging on 16 occasions with single-photon emission computed tomography (SPECT) using 99Tc labelled hexa- methylpropylenamide oxime (HMPAO) as the tracer. Gestational age was 26-32 weeks. Transcutaneous carbon dioxide was between 4.7 and 8.5 kPa and mean arterial blood pressure between 22 and 55 mmHg. Results: There was no statistically significant direct relation between white matter blood flow percentage and any of the variables. Using non-linear regression, however, assuming a plateau over a certain blood pressure threshold and a positive slope below this threshold, the relation to white matter flow percentage was statistically significant (p = 0.02). The threshold was 29 mmHg (95% confidence limits 26-33). Conclusion: Our analysis supports the concept of periventricular white matter as selectively vulnerable to ischaemia during episodes of low blood pressure.
| Original language | English |
|---|---|
| Journal | Acta Paediatrica |
| Volume | 99 |
| Issue number | 10 |
| Pages (from-to) | 1489-92 |
| Number of pages | 4 |
| ISSN | 0803-5253 |
| DOIs | |
| Publication status | Published - 1 Oct 2010 |