RT Journal Article SR Electronic T1 Cerebral autoregulation in premature infants during the first 96 hours of life and relationship to adverse outcomes JF Archives of Disease in Childhood - Fetal and Neonatal Edition JO Arch Dis Child Fetal Neonatal Ed FD BMJ Publishing Group Ltd and Royal College of Paediatrics and Child Health SP F473 OP F479 DO 10.1136/archdischild-2018-315725 VO 104 IS 5 A1 Suma B Hoffman A1 Yun-Ju Cheng A1 Laurence S Magder A1 Narendra Shet A1 Rose M Viscardi YR 2019 UL http://fn.bmj.com/content/104/5/F473.abstract AB Objective To test the hypothesis that impaired cerebral autoregulation (ICA) increases the susceptibility of premature infants to adverse outcomes, we determined the relationship of ICA and cerebral reactivity (CR) measured in the first 96 hours of life to the outcome of grade 3 or 4 intraventricular haemorrhage (IVH) and/or death within 1 month.Setting Single-centre level IV neonatal intensive care unit.Patients Neonates 24–29 weeks’ gestation less than 12 hours old with invasive blood pressure monitoring.Design Cerebral saturations and mean arterial blood pressure were recorded every 30 s for 96 hours. For each 10 min epoch, the correlation coefficient (r) was calculated for mean arterial blood pressure versus cerebral saturations. The epoch was considered to have ICA if r>0.5 and CR if r<0.Results Sixty-one subjects were included. During the first 96 hours, ICA occurred 17.6% and CR occurred 41% of recorded time. In those without adverse outcomes, ICA decreased and CR increased by postnatal day (p<0.05). Adjusted for birth weight and gestational age, those with IVH and those who died spent more time with ICA and less time with CR (p<0.05) over the entire recording period. Those with IVH had 1.5-fold increase in time with ICA on day 2 (p=0.021), and decrease in time with CR on day 3 (p=0.036). Compared with survivors, non-survivors spent more time with ICA on days 3 and 4 (p<0.005), and less with CR on day 3 (p=0.032).Conclusion ICA and CR vary by postnatal day and these patterns are associated with adverse outcomes.