Abstract
predominant increase in tHb suggest a respiratory origin. Thus we hypothesize that with straining, as during a Valsalva maneuver, the increase in intrathoracic pressure compresses veins and impedes cerebral venous return. Increased pressure within the cerebral venous circulation then could lead to microcirculatory congestion and altered blood flow patterns. The marked increase in cerebral blood volume, demonstrated here in preterm infants with hypertensive peaks, provides a possible explanation for the increased incidence of intraventricular hemorrhage in this population. 8 The associated repeated shifts to greater cyt aa3 reduction raises an additional concern about the adequacy and constancy of cellular oxygenation during these periods of blood pressure instability.
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