PMID- 27165896
OWN - NLM
STAT- MEDLINE
DCOM- 20170711
LR  - 20170713
IS  - 0065-1419 (Print)
IS  - 0065-1419 (Linking)
VI  - 122
DP  - 2016
TI  - The Diastolic Closing Margin Is Associated with Intraventricular Hemorrhage in 
      Premature Infants.
PG  - 147-50
LID - 10.1007/978-3-319-22533-3_30 [doi]
AB  - Premature infants are at an increased risk of intraventricular hemorrhage (IVH). 
      The roles of hypotension and hyperemia are still debated. Critical closing 
      pressure (CrCP) is the arterial blood pressure (ABP) at which cerebral blood flow 
      (CBF) ceases. When diastolic ABP is equal to CrCP, CBF occurs only during 
      systole. The difference between diastolic ABP and CrCP is the diastolic closing 
      margin (DCM). We hypothesized that a low DCM was associated with IVH. One hundred 
      eighty-six premature infants, with a gestational age (GA) range of 23-33 weeks, 
      were monitored with umbilical artery catheters and transcranial Doppler 
      insonation of middle cerebral artery flow velocity for 1-h sessions over the 
      first week of life. CrCP was calculated linearly and using an impedance model. A 
      multivariate generalized linear regression model was used to determine 
      associations with severe IVH (grades 3-4). An elevated DCM by either method was 
      associated with IVH (p < 0.0001 for the linear method; p < 0.001 for the 
      impedance model). Lower 5-min Apgar scores, elevated mean CBF velocity, and lower 
      mean ABP were also associated with IVH (p < 0.0001). Elevated DCM, not low DCM, 
      was associated with severe IVH in this cohort.
FAU - Rhee, Christopher J
AU  - Rhee CJ
AD  - Department of Pediatrics, Section of Neonatology, Texas Children's 
      Hospital/Baylor College of Medicine, 6621 Fannin Street, W6-104, Houston, TX, 
      USA. cjrhee@texaschildrens.org.
FAU - Kibler, Kathleen K
AU  - Kibler KK
AD  - Departments of Anesthesiology, Critical Care Medicine, and Pediatrics, Texas 
      Children's Hospital/Baylor College of Medicine, Houston, TX, USA.
FAU - Easley, R Blaine
AU  - Easley RB
AD  - Departments of Anesthesiology, Critical Care Medicine, and Pediatrics, Texas 
      Children's Hospital/Baylor College of Medicine, Houston, TX, USA.
FAU - Andropoulos, Dean B
AU  - Andropoulos DB
AD  - Departments of Anesthesiology, Critical Care Medicine, and Pediatrics, Texas 
      Children's Hospital/Baylor College of Medicine, Houston, TX, USA.
FAU - Czosnyka, Marek
AU  - Czosnyka M
AD  - Division of Neurosurgery, Department of Clinical Neurosciences, University of 
      Cambridge, Cambridge, UK.
FAU - Smielewski, Peter
AU  - Smielewski P
AD  - Division of Neurosurgery, Department of Clinical Neurosciences, University of 
      Cambridge, Cambridge, UK.
FAU - Varsos, Georgios V
AU  - Varsos GV
AD  - Department of Academic Neurosurgery, Addenbrooke's Hospital, University of 
      Cambridge, Cambridge, UK.
FAU - Brady, Ken M
AU  - Brady KM
AD  - Departments of Anesthesiology, Critical Care Medicine, and Pediatrics, Texas 
      Children's Hospital/Baylor College of Medicine, Houston, TX, USA.
FAU - Rusin, Craig G
AU  - Rusin CG
AD  - Department of Cardiology, Texas Children's Hospital/Baylor College of Medicine, 
      Houston, TX, USA.
FAU - Fraser, Charles D 3rd
AU  - Fraser CD 3rd
AD  - University of Texas at Houston School of Medicine, Houston, TX, USA.
FAU - Gauss, C Heath
AU  - Gauss CH
AD  - Department of Biostatistics, University of Arkansas for Medical Sciences, Little 
      Rock, AR, USA.
FAU - Williams, D Keith
AU  - Williams DK
AD  - Department of Biostatistics, University of Arkansas for Medical Sciences, Little 
      Rock, AR, USA.
FAU - Kaiser, Jeffrey R
AU  - Kaiser JR
AD  - Department of Pediatrics, Section of Neonatology, Texas Children's 
      Hospital/Baylor College of Medicine, 6621 Fannin Street, W6-104, Houston, TX, 
      USA.
LA  - eng
GR  - K23 NS043185/NS/NINDS NIH HHS/United States
GR  - P20 RR020146/RR/NCRR NIH HHS/United States
GR  - R01 NS060674/NS/NINDS NIH HHS/United States
PT  - Journal Article
PT  - Research Support, N.I.H., Extramural
PT  - Research Support, Non-U.S. Gov't
PL  - Austria
TA  - Acta Neurochir Suppl
JT  - Acta neurochirurgica. Supplement
JID - 100962752
SB  - IM
MH  - Apgar Score
MH  - Arterial Pressure/*physiology
MH  - Cerebral Hemorrhage/*epidemiology
MH  - *Cerebral Ventricles
MH  - Cerebrovascular Circulation/*physiology
MH  - Diastole/*physiology
MH  - Female
MH  - Humans
MH  - Infant, Extremely Premature
MH  - Infant, Newborn
MH  - Infant, Premature
MH  - Linear Models
MH  - Male
MH  - Middle Cerebral Artery/*diagnostic imaging
MH  - Monitoring, Physiologic
MH  - Multivariate Analysis
MH  - Odds Ratio
MH  - Severity of Illness Index
MH  - Ultrasonography, Doppler, Transcranial
OTO - NOTNLM
OT  - Critical closing pressure
OT  - Diastolic closing margin
OT  - Hypertension
OT  - Hypotension
OT  - Intraventricular hemorrhage
OT  - Prematurity
EDAT- 2016/05/12 06:00
MHDA- 2017/07/14 06:00
CRDT- 2016/05/12 06:00
PHST- 2016/05/12 06:00 [entrez]
PHST- 2016/05/12 06:00 [pubmed]
PHST- 2017/07/14 06:00 [medline]
AID - 10.1007/978-3-319-22533-3_30 [doi]
PST - ppublish
SO  - Acta Neurochir Suppl. 2016;122:147-50. doi: 10.1007/978-3-319-22533-3_30.