Journal article
Elevated Diastolic Closing Margin Is Associated with Intraventricular Hemorrhage in Premature Infants
The Journal of pediatrics, Vol.174, pp.52-56
07/01/2016
DOI: 10.1016/j.jpeds.2016.03.066
PMCID: PMC4925245
PMID: 27112042
Abstract
Objective To determine whether the diastolic closing margin (DCM), defined as diastolic blood pressure minus critical closing pressure, is associated with the development of early severe intraventricular hemorrhage (IVH).
Study design A reanalysis of prospectively collected data was conducted. Premature infants (gestational age 2331 weeks) receiving mechanical ventilation (n = 185) had similar to 1-hour continuous recordings of umbilical arterial blood pressure, middle cerebral artery cerebral blood flow velocity, and PaCO2 during the first week of life. Models using multivariate generalized linear regression and purposeful selection were used to determine associations with severe IVH.
Results Severe IVH (grades 3-4) was observed in 14.6% of the infants. Irrespective of the model used, Apgar score at 5 minutes and DCM were significantly associated with severe IVH. A clinically relevant 5-mmHg increase in DCM was associated with a 1.83-to 1.89-fold increased odds of developing severe IVH.
Conclusion Elevated DCM was associated with severe IVH, consistent with previous animal data showing that IVH is associated with hyperperfusion. Measurement of DCM may be more useful than blood pressure in defining cerebral perfusion in premature infants.
Details
- Title: Subtitle
- Elevated Diastolic Closing Margin Is Associated with Intraventricular Hemorrhage in Premature Infants
- Creators
- Christopher J. Rhee - Baylor College of MedicineJeffrey R. Kaiser - Baylor College of MedicineDanielle R. Rios - Baylor College of MedicineKathleen K. Kibler - Baylor College of MedicineR. Blaine Easley - Baylor College of MedicineDean B. Andropoulos - Baylor College of MedicineMarek Czosnyka - Addenbrooke's HospitalPeter Smielewski - Addenbrooke's HospitalGeorgios V. Varsos - Addenbrooke's HospitalCraig G. Rusin - Baylor College of MedicineC. Heath Gauss - University of Arkansas for Medical SciencesD. Keith Williams - University of Arkansas for Medical SciencesKen M. Brady - Texas Children's Hospital
- Resource Type
- Journal article
- Publication Details
- The Journal of pediatrics, Vol.174, pp.52-56
- DOI
- 10.1016/j.jpeds.2016.03.066
- PMID
- 27112042
- PMCID
- PMC4925245
- NLM abbreviation
- J Pediatr
- ISSN
- 0022-3476
- eISSN
- 1097-6833
- Publisher
- Elsevier
- Number of pages
- 5
- Grant note
- 1UL1RR029884 / University of Arkansas for Medical Sciences Translational Research Institute K23NS091382 / NATIONAL INSTITUTE OF NEUROLOGICAL DISORDERS AND STROKE; United States Department of Health & Human Services; National Institutes of Health (NIH) - USA; NIH National Institute of Neurological Disorders & Stroke (NINDS) P20RR020146 / NATIONAL CENTER FOR RESEARCH RESOURCES; United States Department of Health & Human Services; National Institutes of Health (NIH) - USA; NIH National Center for Research Resources (NCRR) 1K23NS43185; RR20146; 1R01NS060674; 1K23NS091382-01A1 / National Institutes of Health; United States Department of Health & Human Services; National Institutes of Health (NIH) - USA 15MCPRP25670019 / Chao Physician Scientist Award (Baylor College of Medicine, Houston, TX), an American Heart Association
- Language
- English
- Date published
- 07/01/2016
- Academic Unit
- Stead Family Department of Pediatrics; Neonatology
- Record Identifier
- 9984354008502771
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