Low cerebral blood flow is a risk factor for severe intraventricular haemorrhage

Aims-To investigate the relation between cerebral blood flow on the first day of postnatal Life and the severity of any subsequent germinal matrix haemorrhage-intraventricular haemorrhage (GMH-IVH). Methods-Cerebral blood flow was measured in 24 babies during the first 24 hours of life using near infrared spectroscopy. Repeated cerebral ultrasound examination was performed to define the maximum extent of GMH-IVH. Infants were classified as: normal scan, minor periventricular haemorrhage (haemorrhage that resolved), or severe GMH-IVH (haemorrhage distending the ventricles, that progressed to either post haemorrhagic dilatation or porencephalic cyst formation). Results-Cerebral blood flow was significantly lower in the infants with GMH-IVH (median 7.0 ml/100 g/min) than those without haemorrhage (median 12.2 ml/100 g/min), despite no difference in carbon dioxide tension and a higher mean arterial blood pressure. On subgroup analysis, those infants with severe GMH-IVH had the lowest cerebral blood flow. Conclusion-A low cerebral blood flow on the first day of life is associated with the subsequent development of severe intraventricular haemorrhage.