The Journal of Practical Medicine >

2023 , Vol. 39 >Issue 16: 2116 - 2121

DOI: https://doi.org/10.3969/j.issn.1006-5725.2023.16.018

Medical Examination and Clinical Diagnosis

The role of blood pressure variability indicators combined with cerebral blood flow parameters in predicting intraventricular hemorrhage in very low birth weight preterm infants

  • Lijun JIANG ,
  • Qian YU ,
  • Fudong WANG ,
  • Mingfu WU ,
  • Zhifeng LIU ,
  • Longfeng ZHANG ,
  • Libing. ZHANG
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  • *.Hospital Affiliated to Yangzhou University，Yangzhou 225001，China

Received date: 2023-05-06

  Online published: 2023-09-26

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Abstract

Objective Hemodynamic instability is the main factor in the development of intraventricular hemorrhage （IVH） in preterm infants. The purpose of this study is to evaluate the predictive value of blood pressure variability （BPV） and anterior cerebral artery （ACA） blood flow parameters in IVH in preterm infants with gestational age ≤ 32 weeks and birth weight ≤ 1 500 g. Methods Preterm infants with gestational age ≤32 weeks and birth weight ≤ 1500 g admitted to the neonatal intensive care unit （NICU） were selected as the research subjects. All preterm infants were admitted within 1 hour after birth， and systolic blood pressure （SBP）， diastolic blood pressure （DBP）， and mean arterial blood pressure （MABP） were monitored every 1 hour interval. The difference between maximum and minimum values （max?min）， standard deviation （SD）， coefficient of variation （CV）， and successive variation （SV） were used as BPV indicators. On the 1st， 3rd， and 7th day of admission， transcranial ultrasound examination was performed to screen for the occurrence of IVH. On the 1st day， systolic velocity （Vs）， diastolic velocity （Vd）， and resistance index （RI） of ACA were measured simultaneously. Preterm infants were divided into IVH group and non IVH group based on the results of transcranial ultrasound examination， and the correlation between BPV indicators， ACA blood flow parameters， and the development of IVH was analyzed. Results A total of 92 preterm infants met the inclusion criteria， including 49 in the IVH group and 43 in the non IVH group. There was no statistically significant difference in baseline characteristics such as gestational age， birth weight， gender， and perinatal medical history between the two groups of preterm infants （P > 0.05）. SBP SD （OR = 1.480 95% CI：1.020 ~ 2.147）， and ACA?RI （OR = 3.027 95% CI： 2.769 ~ 3.591） are independent risk factors for IVH in preterm infants. The sensitivity and specificity of combined detection of SBP SD， and ACA?RI in predicting IVH were 61.2% and 79.1%， respectively. Conclusion High BPV and ACA?RI are related to IVH in preterm infants with gestational age ≤ 32 weeks and birth weight ≤ 1 500 g. Combined detection of SBP SD， and ACA?RI has a certain predictive effect on early identification of IVH.

Key words： preterm infant; intraventricular hemorrhage; blood pressure; blood pressure variability; ACA resistance index; transcranial doppler

Cite this article

Lijun JIANG , Qian YU , Fudong WANG , Mingfu WU , Zhifeng LIU , Longfeng ZHANG , Libing. ZHANG . The role of blood pressure variability indicators combined with cerebral blood flow parameters in predicting intraventricular hemorrhage in very low birth weight preterm infants[J]. The Journal of Practical Medicine, 2023 , 39(16) : 2116 -2121 . DOI: 10.3969/j.issn.1006-5725.2023.16.018

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