Changes in the perfusion waveform of the internal cerebral vein and intraventricular hemorrhage in the acute management of extremely low-birth-weight infants

This prospective observational study aimed to investigate the association between changes in the Doppler perfusion waveform of the internal cerebral vein and risk of intraventricular hemorrhage (IVH) in extremely low-birth-weight (ELBW) infants. We evaluated the perfusion waveform of the internal cerebral vein every 8 h from immediately after birth to 144 h post-birth in 80 ELBW infants (< 1,000 g) in our hospital. Fluctuations in the measured perfusion waveform were categorized into four patterns according to their increasing magnitude, from grade 0 (steady flow waveform) to grade 3; the IVH rate was investigated. Infants with grades 0-1 fluctuations of the perfusion waveform were classified as low grade (n = 55), and those with grades 2-3 fluctuations were classified as high grade (n = 25). The IVH rate was significantly higher in the high-grade group than the low-grade group (28 vs. 1 %, p < 0.001). The IVH group (n = 8) showed a significantly greater rate of high-grade perfusion waveform than the non-IVH group (n = 72) (87 vs. 25 %, p < 0.001). Conclusion: Changes in the perfusion waveform of the internal cerebral vein during the acute management of ELBW infants may be associated with IVH.