Cerebral fractional oxygen extraction in very low birth weight infants is high when there is low left ventricular output and hypocarbia but is unaffected by hypotension.

Abstract:

:This study examined the relationships between cerebral fractional oxygen extraction (FOE), mean arterial blood pressure (MABP), left ventricular output (LVO), blood gases, and other physiologic variables in 36 very-low-birth-weight preterm infants during the first 3 d after birth. There was a decrease in cerebral FOE (p = 0.008), and rises in LVO (p < 0.0001) and MABP (p = 0.02) during the 3 d. Between d 1 and 2, cerebral FOE decreased (p = 0.007) and LVO increased (p < 0.0001). There was no relationship between MABP and cerebral FOE. LVO correlated negatively with cerebral FOE on d 1 (p = 0.01), but not on d 2 (p = 0.07). On d 1, median pressure of arterial CO(2) was lower in infants with low LVO (<5(th) centile) and high cerebral FOE (>95(th) centile) than in infants with low LVO (<5(th) centile) but normal cerebral FOE (5(th)-95(th) centile) (p = 0.03). These findings suggest that cerebral FOE was increased only when LVO was low and there was hypocarbia. MABP had no demonstrable effect. It is likely that increased cerebral FOE is a normal physiologic response to maintain an adequate oxygen supply to the cerebral tissues when LVO is low and hypocarbia has caused vasoconstriction. It is possible that the cerebral hemispheres are low-priority vascular beds in the preterm infant, and that the high cerebral FOE is a result of reduced hemispheric blood flow to maintain MABP in the presence of low LVO.

journal_name

Pediatr Res

journal_title

Pediatric research

authors

Kissack CM,Garr R,Wardle SP,Weindling AM

doi

10.1203/01.PDR.0000111288.87002.3A

subject

Has Abstract

pub_date

2004-03-01 00:00:00

pages

400-5

issue

3

eissn

0031-3998

issn

1530-0447

pii

01.PDR.0000111288.87002.3A

journal_volume

55

pub_type

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