Intracranial Pressure in Preterm Infants: Effects of Nursing and Parental Care

Abstract

Periventricular-intraventricular hemorrhage (PVH-IVH) is a major cause of both short and long term morbidity and increased mortality in small (<1500 gm) preterm (<34 wks G.A.) infants (Papile et al. 1978). The etiology of PVH-IVH in the preterm remains unclear. The incidence of PVH-IVH is increased in the presence of events that lead to changes in cerebral vascular hemodynamics. The preterm is also vulnerable because of impaired vascular autoregulatory mechanisms and the fragility of the highly vascular periventricular germinal matrix (Brann 1985). Changes in cerebral hemodynamics are reflected in changes in intracranial pressure (ICP) which can be measured non-invasively using a transfontanel pressure monitor (Bada 1983). Various activities, many related to nursing care, are associated with transient or sustained changes in ICP in adults and children (Mitchell 1986), but have not been studied in preterm infants.