Skip to main content
SpringerLink
Log in

Changes in the perfusion waveform of the internal cerebral vein and intraventricular hemorrhage in the acute management of extremely low-birth-weight infants

  • Original Article
  • Published:
European Journal of Pediatrics Aims and scope Submit manuscript

Abstract

This prospective observational study aimed to investigate the association between changes in the Doppler perfusion waveform of the internal cerebral vein and risk of intraventricular hemorrhage (IVH) in extremely low-birth-weight (ELBW) infants. We evaluated the perfusion waveform of the internal cerebral vein every 8 h from immediately after birth to 144 h post-birth in 80 ELBW infants (<1,000 g) in our hospital. Fluctuations in the measured perfusion waveform were categorized into four patterns according to their increasing magnitude, from grade 0 (steady flow waveform) to grade 3; the IVH rate was investigated. Infants with grades 0–1 fluctuations of the perfusion waveform were classified as low grade (n = 55), and those with grades 2–3 fluctuations were classified as high grade (n = 25). The IVH rate was significantly higher in the high-grade group than the low-grade group (28 vs. 1 %, p < 0.001). The IVH group (n = 8) showed a significantly greater rate of high-grade perfusion waveform than the non-IVH group (n = 72) (87 vs. 25 %, p < 0.001). Conclusion: Changes in the perfusion waveform of the internal cerebral vein during the acute management of ELBW infants may be associated with IVH.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1
Fig. 2
Fig. 3
Fig. 4

Similar content being viewed by others

Abbreviations

CI:

Confidence interval

IVH:

Intraventricular hemorrhage

OR:

Odds ratio

References

  1. Badiee Z (2007) Intraventricular hemorrhage in very low birth weight infants. Associated risk factors in Isfahan, Iran. Saudi Med J 28:1362–1366

    PubMed  Google Scholar 

  2. Bolisetty S, Dhawan A, Abdel-Latif M, Bajuk B, Stack J, Lui K (2014) Intraventricular hemorrhage and neurodevelopmental outcomes in extreme preterm infants. Pediatrics 133:55–62. doi:10.1542/peds.2013-0372

    Article  PubMed  Google Scholar 

  3. Crowley P (2006) Prophylactic corticosteroids for preterm birth. Cochrane Database Syst Rev 2:CD000065

    Google Scholar 

  4. Heuchan AM, Evans N, Smart DJH, Simpson JM (2002) Perinatal risk factors for major intraventricular haemorrhage in the Australian and New Zealand Neonatal Network, 1995–97. Arch Dis Child Fetal Neonatal Ed 86:F86–F90

    Article  PubMed Central  CAS  PubMed  Google Scholar 

  5. Hintz SR, Kendrick DE, Wilson-Costello DE, Das A, Bell EF, Vohr BR, Higgins RD (2011) Early-childhood neurodevelopmental outcomes are not improving for infants born at <25 weeks’ gestational age. Pediatrics 127:62–70. doi:10.1542/peds.2010-11

    Article  PubMed Central  PubMed  Google Scholar 

  6. Inder TE, Volpe JJ (2000) Mechanisms of perinatal brain injury. In: Seminars in neonatology, vol 1. Elsevier, pp 3–16

  7. Jodeiry B, Heidarzadeh M, Sahmani-Asl S, Hoseini M, Javaherizadeh H, Eliasi S, Abedini K (2012) Study of intraventricular hemorrhage in VLBW neonates admitted in Al-Zahra Hospital, Tabriz, Iran. Niger J Med 21:92–97

    CAS  PubMed  Google Scholar 

  8. Kono Y, Mishina J, Yonemoto N, Kusuda S, Fujimura M (2011) Neonatal correlates of adverse outcomes in very low-birthweight infants in the NICU Network. Pediatr Int 53:930–935. doi:10.1111/j.1442-200X.2011.03424.x

    Article  PubMed  Google Scholar 

  9. Kusuda S, Fujimura M, Sakuma I, Aotani H, Kabe K, Itani Y, Ichiba H, Matsunami K, Nishida H (2006) Morbidity and mortality of infants with very low birth weight in Japan: center variation. Pediatrics 118:e1130–e1138

    Article  PubMed  Google Scholar 

  10. Miall-Allen V, De Vries L, Whitelaw A (1987) Mean arterial blood pressure and neonatal cerebral lesions. Arch Dis Child 62:1068–1069

    Article  PubMed Central  CAS  PubMed  Google Scholar 

  11. Papile L-A, Burstein J, Burstein R, Koffler H (1978) Incidence and evolution of subependymal and intraventricular hemorrhage: a study of infants with birth weights less than 1,500 gm. J Pediatr 92:529–534

    Article  CAS  PubMed  Google Scholar 

  12. Patra K, Wilson-Costello D, Taylor HG, Mercuri-Minich N, Hack M (2006) Grades I-II intraventricular hemorrhage in extremely low birth weight infants: effects on neurodevelopment. J Pediatr 149:169–173

    Article  PubMed  Google Scholar 

  13. Perrone S, Toti P, Toti MS, Badii S, Becucci E, Gatti MG, Marzocchi B, Picardi A, Buonocore G (2012) Perinatal outcome and placental histological characteristics: a single-center study. J Matern Fetal Neonatal Med 25:110–113

    Article  PubMed  Google Scholar 

  14. Practice CO (2002) Committee opinion: antenatal corticosteroid therapy for fetal maturation. Obstet Gynecol 99:871–873

    Article  Google Scholar 

  15. Roberts D, Dalziel S (2006) Antenatal corticosteroids for accelerating fetal lung maturation for women at risk of preterm birth. Cochrane Database Syst Rev 3

  16. Sherlock RL, Anderson PJ, Doyle LW (2005) Neurodevelopmental sequelae of intraventricular haemorrhage at 8 years of age in a regional cohort of ELBW/very preterm infants. Early Hum Dev 81:909–916

    Article  CAS  PubMed  Google Scholar 

  17. Soraisham AS, Singhal N, McMillan DD, Sauve RS, Lee SK (2008) A multicenter study on the clinical outcome of chorioamnionitis in preterm infants. Am J Obstet Gynecol 200:372.e371–372.e376. doi:10.1016/j.ajog.2008.11.034

    Google Scholar 

  18. Toyoshima K, Kawataki M, Ohyama M, Shibasaki J, Yamaguchi N, Hoshino R, Itani Y, Nakazawa M (2013) Tailor-made circulatory management based on the stress–velocity relationship in preterm infants. J Formos Med Assoc 112:510–517. doi:10.1016/j.jfma.2013.02.011

    Article  PubMed  Google Scholar 

  19. Vergani P, Locatelli A, Doria V, Assi F, Paterlini G, Pezzullo JC, Ghidini A (2004) Intraventricular hemorrhage and periventricular leukomalacia in preterm infants. Obstet Gynecol 104:225–231

    Article  PubMed  Google Scholar 

  20. Volpe JJ (1981) Neonatal intraventricular hemorrhage. N Engl J Med 304:886–891. doi:10.1056/NEJM198104093041506

    Article  CAS  PubMed  Google Scholar 

  21. Volpe JJ (2001) Hypoxic-ischemic encephalopathy: biochemical and physiological aspects. In: Saunders WB (ed) Neurology of the newborn. 5th edn., Philadelphia, pp 247–324

  22. Volpe JJ (2001) Intracranial hemorrhage: germinal matrix-intraventricular hemorrhage. In: Saunders WB (ed) Neurology of the newborn. 5th edn., Philadelphia, pp 517–588

  23. Volpe JJ (2001) Specialized studies in the neurological evaluation. In: Saunders WB (ed) Neurology of the newborn. 5th edn., Philadelphia, pp 154–202

Download references

Ethical statement

Informed consent was obtained from the parents or legal guardians of each infant enrolled in the study. The present study was approved by the appropriate ethics committee and has therefore been performed in accordance with the ethical standards laid down in the 1964 Declaration of Helsinki and its later amendments.

Conflict of interest

The authors declare that they have no conflict of interest and no financial relationship with the organization that sponsored the research.

Author information

Authors and Affiliations

  1. Department of Neonatology, Perinatal Center of Aomori Prefectural Central Hospital, 2-1-1, Higashitsukurimichi, Aomori-shi, Aomori, 030-8553, Japan

    Toshifumi Ikeda, Takasuke Amizuka, Yuya Ito, Ryosuke Mikami, Koji Matsuo, Naoto Kawamura & Shintaro Fusagawa

Authors
  1. Toshifumi Ikeda
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Takasuke Amizuka
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Yuya Ito
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Ryosuke Mikami
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Koji Matsuo
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. Naoto Kawamura
    View author publications

    You can also search for this author in PubMed Google Scholar

  7. Shintaro Fusagawa
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Toshifumi Ikeda.

Additional information

Communicated by Patrick Van Reempts

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Ikeda, T., Amizuka, T., Ito, Y. et al. Changes in the perfusion waveform of the internal cerebral vein and intraventricular hemorrhage in the acute management of extremely low-birth-weight infants. Eur J Pediatr 174, 331–338 (2015). https://doi.org/10.1007/s00431-014-2396-1

Download citation

  • Received:

  • Revised:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00431-014-2396-1

Keywords

Search

Navigation