Archives of disease in childhood. Fetal and neonatal edition · 2008
Cerebral blood volume changes during closure by surgery of patent ductus arteriosus.
СтатьяПоддержка исследования: вне правительства СШАНазвание и аннотация: Перевод в очереди
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Hüning B M, Asfour B, König S, Hess N, Roll C
Аннотация
BACKGROUND: Surgical closure of a patent ductus arteriosus (PDA) in very low birth weight (VLBW) infants has been associated with impaired neurodevelopmental outcome. Surgical PDA closure may result in abrupt changes of cerebral haemodynamics.
OBJECTIVE: To examine the cerebral blood volume changes occurring after surgical closure of PDA.
DESIGN: Continuous cerebral near-infrared spectroscopy (NIRS) recording throughout PDA surgery.
SETTING: Tertiary neonatal intensive care unit, with PDA surgery performed on the ward.
PATIENTS: Ten VLBW infants, median birth weight 748 g (range 590-1070), gestational age 24 (23-27) weeks, chronological age 14 (12-22) days.
INTERVENTION: Surgical closure of PDA.
MAIN OUTCOME MEASURES: Changes in cerebral oxygenated haemoglobin, cerebral deoxygenated haemoglobin, and tissue oxygenation index (measured), changes in cerebral blood volume (CBV) and cerebral haemoglobin difference (calculated) as measured by NIRS.
RESULTS: During the first 2 minutes after closure of the PDA, CBV increased significantly (mean (SD) 0.14 (0.12) ml/100 g tissue; p = 0.01) and returned to baseline within 2-5 minutes. Cerebral oxygenation did not change.
CONCLUSIONS: There is a short-lasting increase in CBV immediately after surgical closure of PDA, but no change in cerebral oxygenation. These transient changes are unlikely to cause harm.
OBJECTIVE: To examine the cerebral blood volume changes occurring after surgical closure of PDA.
DESIGN: Continuous cerebral near-infrared spectroscopy (NIRS) recording throughout PDA surgery.
SETTING: Tertiary neonatal intensive care unit, with PDA surgery performed on the ward.
PATIENTS: Ten VLBW infants, median birth weight 748 g (range 590-1070), gestational age 24 (23-27) weeks, chronological age 14 (12-22) days.
INTERVENTION: Surgical closure of PDA.
MAIN OUTCOME MEASURES: Changes in cerebral oxygenated haemoglobin, cerebral deoxygenated haemoglobin, and tissue oxygenation index (measured), changes in cerebral blood volume (CBV) and cerebral haemoglobin difference (calculated) as measured by NIRS.
RESULTS: During the first 2 minutes after closure of the PDA, CBV increased significantly (mean (SD) 0.14 (0.12) ml/100 g tissue; p = 0.01) and returned to baseline within 2-5 minutes. Cerebral oxygenation did not change.
CONCLUSIONS: There is a short-lasting increase in CBV immediately after surgical closure of PDA, but no change in cerebral oxygenation. These transient changes are unlikely to cause harm.