Effect of dexamethasone therapy on cerebral and ocular blood flow velocity in premature infants studied by colour Doppler flow imaging |
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Institution: | (1) Department of Paediatrics, La Paz Children’s Hospital, Paseo de la Castellana 261, E-28046 Madrid, Spain Tel.: +(34 1) 358-1312; ext 2277; Fax: +(34 1) 358-2545, ES |
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Abstract: | Although dexamethasone (DEX) is used widely in neonates with chronic, and even recently with acute respiratory disease, its
potential side-effects on human cerebral and ocular haemodynamics remain unknown. The effects of DEX on cerebral and ocular
blood flow velocities were assessed in preterm infants with lung disease and mechanical ventilation. Ten ventilated preterm
infants received DEX (0.25 mg/kg/12 h) for ongoing chronic lung disease or extubation failure. Colour Doppler flow imaging
studies of the internal carotid, anterior cerebral and ophthalmic arteries were made before and 10, 30, 60, 120 and 240 min
after the 1st, 3rd, and 5th doses of DEX. Peak systolic, temporal mean, and end-diastolic flow velocities and the resistence
index (RI) of Pourcelot were determined. The brain was examined by ultrasonography before and at the end of each Doppler study.
All patients were continuously monitored for transcutaneous blood gases and blood pressure. All flow velocities and the RI
of the internal carotid, anterior cerebral and ophthalmic arteries showed a similar trend throughout the study. The means
of the values averaged for the 240 min of cerebral and ocular blood flow velocity with each dose were progressively higher
and the values of the RI progressively lower up to the 5th dose. The most significant changes occurred in end-diastolic flow
velocity and consisted of a percentage increase between the 1st and 5th dose of 72% in the internal carotid artery, 102% in
the anterior cerebral artery and 84% in the ophthalmic artery. Changes in arterial blood pressure followed a pattern similar
to that of changes in blood flow velocity.
Conclusions Dexamethasone increments cerebral and ocular blood flow velocity. We speculate that this finding may be relevant to the development
of brain and retinal injury.
Received: 25 July 1995 / Accepted: 28 May 1996 |
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Keywords: | Dexamethasone Chronic lung disease Neonate Cerebral blood flow Ocular blood flow |
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