PERINATOLOGIYA I PEDIATRIYA. 2014. 3(59):79-81; doi 10.15574/PP.2014.59.79 
 

An ultrasound monitoring of the central and cerebral hemodynamics during the therapeutic correction of an arterial hypotension in preterm infants

 Zakrevsky A. M.,  Klymenko T. M.,  Karapetyan O. Y.,  Golyuk K. O.,  Karatay O. S.,  Tomchuk A. I.

Kharkiv Medical Academy of Postgraduate Education, Kharkov, Ukraine

Kharkiv State Perinatal Center, Kharkov, Ukraine

Purpouse: to assess and identify patterns of the type changes of central and cerebral hemodynamics in premature infants with a low and extremely low birth weight infants who were born in asphyxia, for early diagnosis of the nature of the compensation of central hemodynamics and cerebral blood flow, timely correction of the fluid and an inotropic therapy.

Patients and methods: there were analyzed the observations data of 44 premature infants with low and extremely low birth weight infants who were born in asphyxia and were treated at the Kharkiv state perinatal center. In the diagnosis of the nature and extent of intracranial injuries, to determine the therapy tactics among the patients it was used the neurosonography in 10 standard intersections devices LOGIQ-book XP, ULTIMA PRO RADMIR. It was conducted an comprehensive assessment and monitoring of the blood flow in the main vessels of the brain, the during the period of the emergency correction of blood volume and the beginning of inotropic therapy according to the primary reanimation protocol and newborn care. It was assessed the nature of the blood flow, Vmax, Vmin, RI, in the front%cerebral and basilar arteries, the blood character Vmax in the vein of Galen to the saline injection and the beginning of inotropic therapy.

Results: an emergency resumption of circulating blood volume in preterm infants with low and extremely low birth weight with the hypotension should be carried out less-liquid volume – maximum rate of 5 ml/kg, and an inotropic therapy should be adjusted to the current time not more than 10 minutes. The criterion of an effectiveness correction deficiency of blood volume with saline is the resumption of the diastolic velocity in the front-cerebral artery and increasing in the systolic blood pressure.

Conclusions: the premature with low and extremely low birth weight who were born in the severe asphyxia ultrasonic control of central and cerebral hemodynamics in the first 30 minutes in the correction of hypotension mode allows you individually select fluid and the inotropic therapy, preventing the development of undesirable side effects.

Key words: the premature, hypotension, ultrasound central and cerebral hemodynamics.

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