Document Detail


Cerebral autoregulation in neonates with a hemodynamically significant patent ductus arteriosus.
MedLine Citation:
PMID:  22226574     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
OBJECTIVE: Very low birth weight (VLBW) preterm infants are at risk for impaired cerebral autoregulation with pressure passive blood flow. Fluctuations in cerebral perfusion may occur in infants with a hemodynamically significant patent ductus arteriosus (hsPDA), especially during ductal closure. Our goal was to compare cerebral autoregulation using near-infrared spectroscopy in VLBW infants treated for an hsPDA.
STUDY DESIGN: This prospective observational study enrolled 28 VLBW infants with an hsPDA diagnosed by echocardiography and 12 control VLBW infants without an hsPDA. Near-infrared spectroscopy cerebral monitoring was applied during conservative treatment, indomethacin treatment, or surgical ligation. A cerebral pressure passivity index (PPI) was calculated, and PPI differences were compared using a mixed-effects regression model. Cranial ultrasound and magnetic resonance imaging data were also assessed.
RESULTS: Infants with surgically ligated hsPDAs were more likely to have had a greater PPI within 2 hours following ligation than were those treated with conservative management (P=.04) or indomethacin (P=.0007). These differences resolved by 6 hours after treatment.
CONCLUSIONS: Cerebral autoregulation was better preserved after indomethacin treatment of an hsPDA compared with surgical ligation. Infants requiring surgical hsPDA ligation may be at increased risk for cerebral pressure passivity in the 6 hours following surgery.
Authors:
Valerie Y Chock; Chandra Ramamoorthy; Krisa P Van Meurs
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Publication Detail:
Type:  Comparative Study; Journal Article; Research Support, N.I.H., Extramural; Research Support, Non-U.S. Gov't     Date:  2012-01-09
Journal Detail:
Title:  The Journal of pediatrics     Volume:  160     ISSN:  1097-6833     ISO Abbreviation:  J. Pediatr.     Publication Date:  2012 Jun 
Date Detail:
Created Date:  2012-05-25     Completed Date:  2012-07-31     Revised Date:  2014-09-08    
Medline Journal Info:
Nlm Unique ID:  0375410     Medline TA:  J Pediatr     Country:  United States    
Other Details:
Languages:  eng     Pagination:  936-42     Citation Subset:  AIM; IM    
Copyright Information:
Copyright © 2012 Mosby, Inc. All rights reserved.
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MeSH Terms
Descriptor/Qualifier:
Brain / physiopathology*
Cerebrovascular Circulation / physiology*
Ductus Arteriosus, Patent / diagnosis,  physiopathology*
Follow-Up Studies
Homeostasis / physiology*
Humans
Infant, Newborn
Infant, Very Low Birth Weight / physiology*
Magnetic Resonance Imaging
Prospective Studies
Spectroscopy, Near-Infrared
Time Factors
Ultrasonography, Doppler, Transcranial
Grant Support
ID/Acronym/Agency:
KL2 RR025743/RR/NCRR NIH HHS; KL2 RR025743/RR/NCRR NIH HHS; KL2 RR025743-01/RR/NCRR NIH HHS
Comments/Corrections

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