Abstract
We devised a quantitative method to estimate CBF based on the principle of jugular occlusion. With gentle and short compression of both jugular veins there is an increase in head circumference (OFC) which reflects CBF. To make measurements quantitative we differentiated regression of OFC on skull volume: Y=59.1 (X) -1,608, where Y = skull volume and X = OFC. The formula obtained was CBF=355/Y.dx/dt in ml/100g/min. Method entails measurement of (1)OFC, using a mercury strain gauge. Change in OFC is measured as a slope when jugular veins are compressed. (2)Skull volume, using polystyrene cast of the infant's skull filled with water, and volume measured. Comparing values to autopsy brain weights it is accurate within ±4%. (3)Monitoring intracranial venous and arterial flow by Dopplers taped over superior sagittal sinus and nearby artery. When veins are completely occluded flow stops. Alveolar CO2(PACO2) is simultaneously recorded. When values from complete occlusions and no interference with arterial flow are taken, results are reproducible. In 8 preterm infants (G.A. 34wk ±2 S.D.; B.W. 1.8kg ±.6 S.D.; age 9.4 days ±7.9 S.D.)the mean CBF was 67.1 ±13.6 S.E. ml/100g/min. The values are similar to those reported previously using the N2O method. During administration of 2% to 3% CO2, CBF increased to 97 ±24.1 S.E. Mean PACO2 increased from 38.7 ±1.2 to 43.4 ±1.1 S.E.,therefore the increase in CBF per mmHg PACO2 was 6.9 ml/100g/min. The 10% increase in CBF is double that reported for adults. We suggest that CBF in preterm infants is more sensitive to changes in PACO2 than adults.
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Leahy, F., Sankaran, K., Cates, D. et al. 1138 QUANTITATIVE NON-INVASIVE METHOD OF MEASURING CEREBRAL BLOOD FLOW (CBF) IN THE NEWBORN. Pediatr Res 12 (Suppl 4), 553 (1978). https://doi.org/10.1203/00006450-197804001-01144
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DOI: https://doi.org/10.1203/00006450-197804001-01144
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