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CEREBRAL BLOOD FLOW VELOCITY IN VARIOUS CLINICAL EVENTS

Doppler ultrasound measurement of cerebral blood flow velocity (CBFV) measuring pulsatility index (PI), peak systolic velocity, diastolic velocity, and area under the curve was used as adjunct monitoring in neonates to study alterations of cerebrovascular dynamics in various clinical events. Changes in CBFV induced by lumbar puncture (LP) in the treatment of post hemorrhagic hydrocephalus (IVH) and sepsis were evaluated. The effect of exchange transfusion (ETx), pneumothorax (Pn), and the drugs pavulon (Pa), dopamine (Dop), isuprel (Isu), and mannitol (Mann) on CBFV were studied.Effect of LP on CBFV in IVH was dramatic only in infants with very abnormal initial CBFV, two of whom required shunting. In infants with severe RDS, pavulon and dopamine stabilized CBFV; isuprel had no effect. Pneumothorax dramatically affected CBFV adversely, and this effect was not improved after chest tube insertion. Exchange transfusion did not alter CBFV either during or after the procedure. Cerebral blood flow is affected by physiologic perturbation. Monitoring this parameter can be helpful for a better understanding of cerebrovascular hemodynamics.