Circulatory effects of ventilator rate and end-expiratory pressure in unparalysed preterm infants

Authors

  • S Bohin,

    1. Department of Child Health, Leicester University Medical School, Clinical Sciences Building, Leicester Royal Infirmary, Leicester, UK
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  • AC Fenton,

    1. Department of Child Health, Leicester University Medical School, Clinical Sciences Building, Leicester Royal Infirmary, Leicester, UK
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  • JR Thompson,

    1. Department of Ophthalmology, Leicester University Medical School, Clinical Sciences Building, Leicester Royal Infirmary, Leicester, UK
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  • DH Evans,

    1. Department of Medical Physics, Leicester University Medical School, Clinical Sciences Building, Leicester Royal Infirmary, Leicester, UK
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  • DJ Field

    Corresponding author
    1. Department of Child Health, Leicester University Medical School, Clinical Sciences Building, Leicester Royal Infirmary, Leicester, UK
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D J Field, Department of Child Health, Clinical Sciences Building, Leicester Royal Infirmary, PO Box 65, Leicester LE2 7LX, UK

Abstract

Impairment of cerebrovascular autoregulation may be important in the pathogenesis of ischaemic brain injury in preterm infants. A previous study in ventilated preterm infants paralysed with pancuronium showed that changes in cerebral blood flow velocity (CBFV) were related to concomitant changes in arterial blood pressure. In a similar study in unparalysed infants, changes in CBFV in response to changes in ventilator rate or end-expiratory pressure were independent of associated changes in the arterial blood pressure. These results emphasize the importance of avoiding large swings in blood pressure in paralysed infants. Whether alternative paralysing agents have similar effects warrants further study.

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