Abstract
Previous studies in neonates have reported changes in intracranial pressure (ICP) and internal jugular vein (IJV) outflow following changes in head position. To determine the effect of varying head position on cerebral metabolism in healthy infants, brain spectra of phosphorus-containing compounds by 31-P NMR were measured in 6 term and 4 preterm, appropriate-for-gestational-age infants, each with their head in various positions: Body in right and left lateral position, head neutral; supine, head turned 90° right; prone, head turned 90° left. Spectra of phosphomonester (PME), inorganic phosphate (Pi), phosphodiester (PDE), phosphocreatine (PCr) and ATP were obtained using a 2 turn surface coil. PCr/Pi, a critical measure of bioenergetic reserve, intracellular pH, and PME/β ATP were calculated. The mean value for PCr/Pi in the term babies in neutral position was, left = 0.93, right = 1.08. The PCr/Pi following head rotation 90° to the right and in prone position with head 90° to left, was 1.05 and 1.04, respectively. The PME/β ATP in term infants was left = 1.47 and right = 1.81, and after 90° head rotation while supine, 4 of 6 infants showed a ≥10% decrease in PME/β ATP. Preterm infants with head in neutral position had a mean PCr/Pi of 0.99 and 0.91 on the left and right, respectively. Following head rotation, PCr/Pi was 1.11 and in the prone position it was 0.85. Intracellular pH showed no correlation with changes in head position. These data suggest that alterations in ICP or IJV which may accompany changes in head position are not of sufficient magnitude to affect cerebral metabolism in healthy term and preterm infants.
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Lawson, B., Anday, E., Guillet, R. et al. 1435 EFFECT OF VARYING HEAD POSITION ON CEREBRAL 31-P NUCLEAR MAGNETIC RESONANCE (NMR) SPECTROSCOPY. Pediatr Res 19, 350 (1985). https://doi.org/10.1203/00006450-198504000-01459
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DOI: https://doi.org/10.1203/00006450-198504000-01459