The prediction of estimated cerebral perfusion pressure with end diastolic velocity in newborns

Objective To elucidate the relationship between estimated cerebral perfusion pressure (CPPe) and cerebral blood flow velocities (CBFVs) or resistance index (RI) in neonates, and identify optimal Doppler cut-off values for predicting CPPe. Study Design: This multicenter study included neonates with arterial lines admitted to neonatal intensive care units between December 2021 and August 2024. CPPe, CBFVs, and RI were calculated daily from middle cerebral artery. Results A total of 446 samples were obtained from 137 infants with median gestational age of 32 (interquartile range [IQR], 27–36) weeks and median birth weight of 1,551 (IQR, 928-2,292) g. End diastolic velocity (EDV) showed strongest correlation with CPPe (β = 0.571, 95% confidence interval, 0.500–0.641, p  < 0.001). EDV cut-off values increased stepwise with higher CPPe thresholds. Conclusion EDV is a strong predictor of neonatal CPPe and may serve as a practical indicator of cerebral perfusion in neonatal intensive care units.