Background and aims The effects of haemodynamic changes on cerebral and systemic perfusion in infants with perinatal asphyxia are not well understood. We investigated the relationship between cerebral and systemic perfusion, and short-term outcome in infants with asphyxia.
Methods Ten infants (gestation age >35 weeks) with asphyxia (Apgar score <7 at 1 min) were divided into 2 groups: those with hypoxic-ischaemic encephalopathy (HIE; HIE group, n = 4) and those without HIE (non-HIE group, n = 6). Cerebral tissue oxygenation index (TOI) and cerebral fractional tissue oxygen extraction (FTOE) were measured by near-infrared spectroscopy (NIRS) at 12, 24, 48, and 72 h after birth. Superior vena cava (SVC) flow and left ventricular cardiac output (LVCO) were simultaneously measured by echocardiography.
Results TOI was significantly higher and FTOE was significantly lower in the HIE group (n = 4) than in the non-HIE group (n = 6) at all measurement time points. Although SVC flow and LVCO were not significantly different between the 2 groups, they were consistently higher in the HIE group than in the non-HIE group at all measurement time points. We found a positive correlation between SVC flow and LVCO in both groups, and between SVC flow and TOI in the non-HIE group.
Conclusions Combined bedside monitoring of TOI and FTOE by NIRS and SVC flow may be useful for evaluating secondary energy failure and disrupted regulation of brain circulation in infants with asphyxia.