Changes in Cardiac Function and Cerebral Blood Flow in Relation to Peri/Intraventricular Hemorrhage in Extremely Preterm Infants - 22/01/14
, Michael McCoy, MS, ARNP 2, Michael P. Anderson, PhD 3, Faridali Ramji, MD 4, Istvan Seri, MD, PhD 1Abstract |
Objective |
To investigate whether changes in cardiac function and cerebral blood flow (CBF) precede the occurrence of peri/intraventricular hemorrhage (P/IVH) in extremely preterm infants.
Study design |
In this prospective observational study, 22 preterm infants (gestational age 25.9 ± 1.2 weeks; range 23-27 weeks) were monitored between 4 and 76 hours after birth. Cardiac function and changes in CBF and P/IVH were assessed by ultrasound every 12 hours. Changes in CBF were also followed by continuous monitoring of cerebral regional oxygen saturation (rSO2) and by calculating cerebral fractional oxygen extraction.
Results |
Five patients developed P/IVH (1 patient grade II and 4 patients grade IV). Whereas measures of cardiac function and CBF remained unchanged in neonates without P/IVH, patients with P/IVH tended to have lower left ventricular output and had lower left ventricle stroke volume and cerebral rSO2 and higher cerebral fractional oxygen extraction during the first 12 hours of the study. By 28 hours, these variables were similar in the 2 groups and myocardial performance index was lower and middle cerebral artery mean flow velocity higher in the P/IVH group. P/IVH was detected after these changes occurred.
Conclusions |
Cardiac function and CBF remain stable in very preterm neonates who do not develop P/IVH during the first 3 postnatal days. In very preterm neonates developing P/IVH during this period, lower systemic perfusion and CBF followed by an increase in these variables precede the development of P/IVH. Monitoring cardiac function and cerebral rSO2 may identify infants at higher risk for developing P/IVH before the bleeding occurs.
Le texte complet de cet article est disponible en PDF.Keyword : CBF, CFOE, CO2, LVO, MCA, MCA-MV, MPI, NIRS, P/IVH, PDA, rSO2, RVO, SpO2, SVR, US, VCFC
Plan
| Funded by a grant from the section of Neonatal-Perinatal Medicine, Department of Pediatrics, University of Oklahoma Health Sciences Center. Somanetics Corporation (now Covidien) provided the near infrared spectroscopy monitors and sensors for the duration of the study. The authors declare no conflicts of interest. |
Vol 164 - N° 2
P. 264 - février 2014 Retour au numéro
Article précédent
- The Prevalence of Turner Syndrome in Girls Presenting with Coarctation of the Aorta
- Sze Choong Wong, Trent Burgess, Michael Cheung, Margaret Zacharin
- Hypothermia and Early Neonatal Mortality in Preterm Infants
- Maria Fernanda Branco de Almeida, Ruth Guinsburg, Guilherme Assis Sancho, Izilda Rodrigues Machado Rosa, Zeni Carvalho Lamy, Francisco Eulógio Martinez, Regina Paula Guimarães Vieira Cavalcante da Silva, Lígia Silvana Lopes Ferrari, Ligia Maria Suppo de Souza Rugolo, Vânia Olivetti Steffen Abdallah, Rita de Cássia Silveira, Brazilian Network on Neonatal Research ?
Bienvenue sur EM-consulte, la référence des professionnels de santé.
L’accès au texte intégral de cet article nécessite un abonnement.
Déjà abonné à cette revue ?