In:
Neonatology, S. Karger AG, Vol. 119, No. 6 ( 2022), p. 703-711
Abstract:
〈 b 〉 〈 i 〉 Introduction: 〈 /i 〉 〈 /b 〉 Neurodevelopmental impairment is a growing concern for preterm infants who received surgical ligation of patent ductus arteriosus (PDA). We aimed to explore the cerebral hemodynamics during the critical period of PDA ligation. 〈 b 〉 〈 i 〉 Methods: 〈 /i 〉 〈 /b 〉 Very-low-birth-weight (VLBW) preterm infants who underwent PDA ligation were prospectively enrolled. Patients were monitored preoperatively and until 72 h post-ligation. Middle cerebral artery (MCA) flow, regional cerebral oxygen saturation (rcSO 〈 sub 〉 2 〈 /sub 〉 ), and cardiac output were measured through Doppler ultrasound, near-infrared spectroscopy, and electrical cardiometry, respectively. Using rcSO 〈 sub 〉 2 〈 /sub 〉 & #x3c;55% indicating cerebral hypoxia, the duration (% of time) and burden (cumulative negative quantity of rsSO 〈 sub 〉 2 〈 /sub 〉 & #x3c;55% × the period [minutes]) were estimated. An abnormal MCA was defined as an MCA flow of & #x3c;10th percentile of flow velocity or & #x3e;90th percentile of pulsatility or resistance index. Poor outcomes were defined as in-hospital death or neurologic disorders, either neuroimaging or functional abnormalities, upon discharge. 〈 b 〉 〈 i 〉 Results: 〈 /i 〉 〈 /b 〉 Thirty-two VLBW infants were examined, and 15 (46.9%) had poor outcomes. Infants with poor outcomes had significantly longer duration of cerebral hypoxia (5.4 [2.2–32.3] vs. 1.8 [0.4–5.6] %, 〈 i 〉 p 〈 /i 〉 = 0.033) and worse hypoxic burden (2,118 [684–13,549] vs. 622 [88–1,669] %minutes, 〈 i 〉 p 〈 /i 〉 = 0.027). In a linear mixed model, rcSO 〈 sub 〉 2 〈 /sub 〉 was positively correlated with arterial saturation (β 0.860, 95% CI: 0.649–1.070) and negatively correlated with abnormal MCA flow (β −5.287, 95% CI: −8.238 to −2.335). 〈 b 〉 〈 i 〉 Conclusion: 〈 /i 〉 〈 /b 〉 Longer duration of cerebral hypoxia and worse hypoxic burden post-ligation was associated with an increased risk of in-hospital mortality or neurologic disorders upon discharge in VLBW preterm infants.
Type of Medium:
Online Resource
ISSN:
1661-7800
,
1661-7819
Language:
English
Publisher:
S. Karger AG
Publication Date:
2022
detail.hit.zdb_id:
2403535-X
SSG:
12
Permalink
