Fast Doppler as a novel bedside measure of cerebral perfusion in preterm infants

Pediatr Res. 2016 Feb;79(2):333-8. doi: 10.1038/pr.2015.227. Epub 2015 Nov 5.


Background: Altered cerebral perfusion from impaired autoregulation may contribute to the morbidity and mortality associated with premature birth. We hypothesized that fast Doppler imaging could provide a reproducible bedside estimation of cerebral perfusion and autoregulation in preterm infants.

Methods: This is a prospective pilot study using fast Doppler ultrasound to assess blood flow velocity in the basal ganglia of 19 subjects born at 26-32 wk gestation. Intraclass correlation provided a measure of test-retest reliability, and linear regression of cerebral blood flow velocity and heart rate or blood pressure allowed for estimations of autoregulatory ability.

Results: The intraclass correlation when imaging in the first 48 h of life was 0.634. We found significant and independent correlations between the systolic blood flow velocity and both systolic blood pressure and heart rate (P = 0.015 and 0.012 respectively) only in the 26-28 wk gestational age infants in the first 48 h of life.

Conclusion: Our results suggest that fast Doppler provides reliable bedside measurements of cerebral blood flow velocity at the tissue level in premature infants, acting as a proxy for cerebral tissue perfusion. Additionally, autoregulation appears to be impaired in the extremely preterm infants, even within a normal range of blood pressures.

Publication types

  • Observational Study
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Blood Flow Velocity
  • Blood Pressure
  • Cerebrovascular Circulation*
  • Gestational Age
  • Heart Rate
  • Homeostasis
  • Humans
  • Infant, Extremely Premature*
  • Infant, Newborn
  • Linear Models
  • Pilot Projects
  • Point-of-Care Testing*
  • Predictive Value of Tests
  • Prospective Studies
  • Reproducibility of Results
  • Ultrasonography, Doppler, Color*
  • Ultrasonography, Doppler, Transcranial*