Abstract
Low CBF is thought to cause periventricular leukomalacia in premature babies, but a normal outcome has also been observed. Low CBF found after exchange transfusion in lambs was explained by the lower oxygen affinity of adult as compared to fetal hemoglobin (HbF). We studied the influence of relative HbF concentration [HbF] and thus the oxygen affinity on CBF in 41 small premature infants: GA 29.1 ±2.0 wks, BW 1064 ±153 g (mean ±ISD). In cerebral ultrasonography 12 were found normal, 14 had subependymal or intraventricular hemorrhage (SEH/IVH), and 15 had intra-parenchymal anomalies (IPE). CBF was measured with the i.v. Xe-133 method at day 1,3 and 7, and [HbF] was obtained chromatographically. In normal babies a positive correlation between [HbF] and CBF was found: day 1 r= 0.62*, day 3 r=0.64*, day 7 r=0.63* (*=p<0.05). In those with SEH/IVH this correlation was significant only on day 3, in those with IPE only on day 7. Multiple regression analysis including all babies exept IPE showed a significant influence of [HbF] on CBF, independent of BP, pCO2 and Hct. We conclude that normal babies and to a lesser extent those with SEH/IVH or IPE can adapt their CBF to the actual oxygen affinity of blood.
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