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Changes in Cerebral and Visceral Blood Flow Velocities in Asphyxiated Term Neonates With Hypoxic-Ischemic Encephalopathy

Radiology Service (P.I., M.L., L.M.) and Children’s Clinic (I.T., K.M.), Tartu University Hospital, Tartu, Estonia; and Department of Radiology, University of Tartu, Tartu, Estonia (P.I., M.L.).

Address correspondence to Pilvi Ilves, PhD, MD, Department of Radiology, University of Tartu, Puusepa 2, 51014 Tartu, Estonia., E-mail: pilvi.ilves{at}kliinikum.ee

Objective. The purpose of this study was to evaluate changes in the Doppler blood flow velocity (BFV) in the cerebral and visceral arteries in asphyxiated term neonates. Methods. The BFV was measured in 47 asphyxiated and 37 healthy term neonates in the anterior cerebral artery, middle cerebral artery, basilar artery, internal carotid artery, celiac artery (CA), superior mesenteric artery (SMA), and renal artery (RA) up to the age of 60 to 149 days. Results. At the age of 12 to 120 hours after asphyxia, the mean BFV had increased, and the resistive index (RI) had decreased (P < .05) in all cerebral arteries in neonates with severe hypoxic-ischemic encephalopathy (HIE) compared with the control group. In neonates with severe HIE, the mean BFV in the RA had significantly decreased at the age of 3 to 240 hours, and the RI had increased at the age of 24 to 240 hours, normalizing by the age of 21 to 59 days compared with the control group (P < .05). In the SMA, a decreased mean BFV was found in neonates with severe HIE compared with those with mild to moderate HIE only at the age of 24 to 36 hours. In neonates with mild to moderate HIE, the mean BFV had increased in the SMA and CA compared with the control group at the age of 2 to 11.9 hours. Conclusions. A severe alteration of the cerebral and visceral BFV takes place during the first days after asphyxia in neonates with different severities of HIE.

Key Words: cerebral blood flow velocity • hypoxic-ischemic encephalopathy • neonate • sonography • visceral blood flow velocity

Abbreviations: BA, basilar artery • BFV, blood flow velocity • BP, blood pressure • CA, celiac artery • CBFV, cerebral blood flow velocity • CI, confidence interval • HIE, hypoxic-ischemic encephalopathy • RA, renal artery • RI, resistive index • SMA, superior mesenteric artery • TAMV, time mean of the maximum velocity envelope curve • TAV, time-averaged mean velocity