Journal article
Observed and calculated cerebral critical closing pressure are highly correlated in preterm infants
Pediatric research, Vol.86(2), pp.242-246
08/01/2019
DOI: 10.1038/s41390-019-0403-y
PMCID: PMC6658334
PMID: 31003233
Abstract
BACKGROUND: Cerebrovascular critical closing pressure (CrCP) is the arterial blood pressure (ABP) at which cerebral blood flow ceases. Preterm ABP is low and close to CrCP. The diastolic closing margin (diastolic ABP minus CrCP) has been associated with intraventricular hemorrhage in preterm infants. CrCP is estimated from middle cerebral artery cerebral blood flow velocity (CBFV) and ABP waveforms. However, these estimations have not been validated due to a lack of gold standard. Direct observation of the CrCP in preterm infants with hypotension is an opportunity to validate synchronously estimated CrCP.
METHODS: ABP and CBFV tracings were obtained from 24 extremely low birth weight infants. Recordings where diastolic CBFV was zero were identified. The gold standard CrCP was delineated using piecewise regression of ABP and CBFV values paired by rank ordering and then estimated using a published formula. The measured and estimated values were compared using linear regression and Bland-Altman analysis.
RESULTS: Linear regression showed a high degree of correlation between measured and calculated CrCP (r(2) = 0.93).
CONCLUSIONS: This is the first study to validate a calculated CrCP by comparing it to direct measurements of CrCP from preterm infants when ABP is lower than CrCP.
Details
- Title: Subtitle
- Observed and calculated cerebral critical closing pressure are highly correlated in preterm infants
- Creators
- Leah Elizondo - Texas Children's HospitalDanielle R. Rios - Texas Children's HospitalEric Vu - Baylor College of MedicineKathleen Kibler - Baylor College of MedicineR. Blaine Easley - Baylor College of MedicineDean B. Andropoulos - Baylor College of MedicineSebastian Acosta - Texas Children's HospitalCraig G. Rusin - Texas Children's HospitalJeffrey R. Kaiser - Penn State Milton S. Hershey Medical CenterKen M. Brady - Northwestern UniversityChristopher J. Rhee - Baylor College of Medicine
- Resource Type
- Journal article
- Publication Details
- Pediatric research, Vol.86(2), pp.242-246
- Publisher
- Springer Nature
- DOI
- 10.1038/s41390-019-0403-y
- PMID
- 31003233
- PMCID
- PMC6658334
- ISSN
- 0031-3998
- eISSN
- 1530-0447
- Number of pages
- 5
- Grant note
- K23HLI130522; 1K23NS43185; 1RO1NS060674; K23NS091382 / NIH; United States Department of Health & Human Services; National Institutes of Health (NIH) - USA 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) K23HL130522 / NATIONAL HEART, LUNG, AND BLOOD INSTITUTE; United States Department of Health & Human Services; National Institutes of Health (NIH) - USA; NIH National Heart Lung & Blood Institute (NHLBI) Evie Whitlock Grant
- Language
- English
- Date published
- 08/01/2019
- Academic Unit
- Stead Family Department of Pediatrics; Neonatology
- Record Identifier
- 9984353828202771
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