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Dynamic monitoring of cerebral blood flow in ventilated neonates
Neonatal Society Abstracts/ Early
Hum. Dev. 38 (1994) 55-66
57
enterocyte shedding. Dietary LCP could affect lipid absorption by altering enterocyte membrane composition. However, effects of gut flora and milk triglyceride structure need consideration. I 2
Makrides, M., Simmer, K., Goggin, M. and Gibson, R.A. (1993): Pediatr. Res., 34, 425-427. Spencer, S.A., McKenna, S., Stammers, J. and Hull, D. (1992): Early Hum. Dev., 30, 21-31.
of cerebral blood flow in ventilated neonates. P. Krchoa, I. Frica, Z. Tomorib, introduced by Dr Colin Morley. ‘Neonatal Intensive Care Unit, Faculty Hospital, bDept. Pathophysiology, Medical Faculty, Kosice, Slovakia.
Dynamic
monitoring
This was to establish whether dynamic monitoring of cerebral blood flow velocity could give useful information for the ventilatory management of neonates. Methods: Ten ventilated neonates in our intensive care unit were studied. Cerebral blood flow velocity (CBFV) was measured with pulsed Doppler ultrasound (Esaote Biomedica AU 530 with 3.5MHz probe). Measurements were made in the anterior cerebral artery before and after intubation, and during endotracheal suction. Results: Significant changes of CBFV were found soon after intubation when an appropriate response of CBF to the decrease in PCO, was observed. In two cases, no changes were seen: one had serious congenital heart disease and the second case was suffering from pneumonia. Using an on-line method during suctioning, we identified a significant increase in mean and peak velocities and no significant change in pulsatility or resistance indices. Conclusion: Changes in CBFV after suctioning and with carbon dioxide tension have been described before [ 1,2]. From our studies, it seems that P&o1 is the most important determinant of CBFV. Dynamic monitoring of CBFV during intensive care could be used as a quick non-invasive method to assist the determination of ventilatory parameters. Objective:
1 2
Perlman, J.M. and Volpr, J.J. (1983): Suctioning the preterm infant: effects of cerebral blood flow velocity, intracranial pressure and arterial pressure. Pediatrics, 72. 329-334. Van Bel, F. and Van de Bor, M. et al. (1988): The influence of abnormal blood gases on cerebral blood flow velocity in preterm newborns. Neuropaediatrics, 19, 27032.
Once-a-day administration of amikacin in neonates: clinical evidence of the validity of a pharmacokinetic schedule according to the gestational age at birth. J.P. Langhendries, 0. Battisti, P. Wallemacq, Nicu, Rocourt, Liege, Belgium. Introduction: ?? The
bactericidal activity of aminoglycosides (A) is peak-dependent. effect of (A) is linked to the peak/mic ratio. ?? Renal and cochlear uptake of (A) is a saturable process. ?? Postantibiotic
Hum. Dev. 38 (1994) 55-66
57
enterocyte shedding. Dietary LCP could affect lipid absorption by altering enterocyte membrane composition. However, effects of gut flora and milk triglyceride structure need consideration. I 2
Makrides, M., Simmer, K., Goggin, M. and Gibson, R.A. (1993): Pediatr. Res., 34, 425-427. Spencer, S.A., McKenna, S., Stammers, J. and Hull, D. (1992): Early Hum. Dev., 30, 21-31.
of cerebral blood flow in ventilated neonates. P. Krchoa, I. Frica, Z. Tomorib, introduced by Dr Colin Morley. ‘Neonatal Intensive Care Unit, Faculty Hospital, bDept. Pathophysiology, Medical Faculty, Kosice, Slovakia.
Dynamic
monitoring
This was to establish whether dynamic monitoring of cerebral blood flow velocity could give useful information for the ventilatory management of neonates. Methods: Ten ventilated neonates in our intensive care unit were studied. Cerebral blood flow velocity (CBFV) was measured with pulsed Doppler ultrasound (Esaote Biomedica AU 530 with 3.5MHz probe). Measurements were made in the anterior cerebral artery before and after intubation, and during endotracheal suction. Results: Significant changes of CBFV were found soon after intubation when an appropriate response of CBF to the decrease in PCO, was observed. In two cases, no changes were seen: one had serious congenital heart disease and the second case was suffering from pneumonia. Using an on-line method during suctioning, we identified a significant increase in mean and peak velocities and no significant change in pulsatility or resistance indices. Conclusion: Changes in CBFV after suctioning and with carbon dioxide tension have been described before [ 1,2]. From our studies, it seems that P&o1 is the most important determinant of CBFV. Dynamic monitoring of CBFV during intensive care could be used as a quick non-invasive method to assist the determination of ventilatory parameters. Objective:
1 2
Perlman, J.M. and Volpr, J.J. (1983): Suctioning the preterm infant: effects of cerebral blood flow velocity, intracranial pressure and arterial pressure. Pediatrics, 72. 329-334. Van Bel, F. and Van de Bor, M. et al. (1988): The influence of abnormal blood gases on cerebral blood flow velocity in preterm newborns. Neuropaediatrics, 19, 27032.
Once-a-day administration of amikacin in neonates: clinical evidence of the validity of a pharmacokinetic schedule according to the gestational age at birth. J.P. Langhendries, 0. Battisti, P. Wallemacq, Nicu, Rocourt, Liege, Belgium. Introduction: ?? The
bactericidal activity of aminoglycosides (A) is peak-dependent. effect of (A) is linked to the peak/mic ratio. ?? Renal and cochlear uptake of (A) is a saturable process. ?? Postantibiotic