Blood pressure increases, birth weight-dependent stability boundary, and intraventricular hemorrhage

E. H. Perry, H. S. Bada, J. D. Ray, S. B. Korones, K. Arheart, H. L. Magill

Research output: Contribution to journalArticle

43 Scopus citations

Abstract

The blood pressure (BP) and transcutaneous PO2 (TcPO2) changes associated with intensive care procedures were evaluated to determine whether responses differ between babies with and without periventricular-intraventricular hemorrhage (PV-IVH). Fifty-three inborn babies ≤1500 g were studied using a microcomputer-based monitoring system. With almost any procedure including a seemingly benign one such as a diaper change, peak systolic BP increased and TcPO2 decreased. However, responses to interventions did not differ between babies with PV-IVH and those without PV-IVH. Neither did these responses differ between those with birth weight ≤1000 g and >1000 g. When each baby's record was scanned for the highest peak systolic BP before diagnosis of PV-IVH or within 48 hours in those with no PV-IVH and their BP points plotted against birth weight, a stable region was evident wherein PV-IVH occurred at a lower incidence (13%). When peak systolic BP was beyond this stable region, the incidence of PV-IVH was significantly higher, 70% (P < .0001). The stability boundary for the maximum systolic BP is birth weight-dependent; the limit for the highest tolerable peak systolic BP is lower for the low-birth-weight infant. In over 70% of instances the highest peak systolic BP was associated with motor activities either induced by nursery procedures or spontaneous. We speculate that decreasing the frequency of intensive care interventions may decrease episodic BP increases to levels beyond the birth weight-dependent stability boundary where PV-IVH is likely to occur.

Original languageEnglish (US)
Pages (from-to)727-732
Number of pages6
JournalPediatrics
Volume85
Issue number5
StatePublished - 1990

Keywords

  • Blood pressure
  • Intensive care procedures
  • Intraventricular hemorrhage
  • Premature
  • TcPO

ASJC Scopus subject areas

  • Pediatrics, Perinatology, and Child Health

Fingerprint Dive into the research topics of 'Blood pressure increases, birth weight-dependent stability boundary, and intraventricular hemorrhage'. Together they form a unique fingerprint.

Cite this