Abstract
Treatment of posthaemorrhagic ventricular dilatation in neonates is still a matter of debate. In 8 neonates between 26 and 31 weeks with posthemorrhagic hydrocephalus the effect of a decrease in intracranial pressure (ICP) on cerebral oxygenation was evaluated by NIRS. Lumbar puncture (LP) had been performed postnatally between 31 and 38 weeks. All infants had intraventricular haemorrhage grade III or IV (Papille).
Results: (range of the differences between before and after LP in micromoles/liter)
Using Cytaa3 as an index of intracellular O2-availability and HbVol, the sum of oygenated and reduced haemoglobin as a measure of cerebral blood volume, neonates in group 1 with a fast increase of headcircumference, large diastasis and bulged fontanel exhibited a significant raise in Cytaa3 and HbVol (MWU: <0,05) In group 2, which did not have the above mentioned clinical signs of ICP, Cytaa3 remained stable or decreased, while HbVol showed a small raise. These findings gives new insights in the pathophysiological understanding of increased ICP and could have an impact on the therapeutical procedure.
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Von Siebenthai, S., Van Der Vlugt, A., Devlieger, H. et al. EFFECT OF CHANGES IN INTRACRANIAL PRESSURE ON CYTOCHROME AA3 (CYTAA3) AND HAEMOGLOBINVOLUME (HBVOL): A NEAR INFRARED SPECTROSCOPY (NIRS). Pediatr Res 32, 612 (1992). https://doi.org/10.1203/00006450-199211000-00046
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DOI: https://doi.org/10.1203/00006450-199211000-00046