Cerebral autoregulation and activity after propofol for endotracheal intubation in preterm neonates

Liesbeth Thewissen, Alexander Caicedo, Anneleen Dereymaeker, Sabine Van Huffel, Gunnar Naulaers, Karel Allegaert, Anne Smits

Research output: Contribution to journalArticlepeer-review

8 Scopus citations

Abstract

Background: Despite increasing use of propofol in neonates, observations on cerebral effects are limited. Aim: To investigate cerebral autoregulation (CAR) and activity after propofol for endotracheal intubation in preterm neonates. Methods: Twenty-two neonates received propofol before intubation as part of a published dose-finding study. Mean arterial blood pressure (MABP), near-infrared spectroscopy-derived cerebral oxygenation (rScO2), and amplitude-integrated electroencephalography (aEEG) were analyzed until 180 min after propofol. CAR was expressed as transfer function (TF) gain, indicating % change in rScO2 per 1 mmHg change in MABP. Values exceeding mean TF gain + 2 standard deviations (SD) defined impaired CAR. Results: After intubation with a median propofol dose of 1 (0.5–4.5) mg/kg, rScO2 remained stable during decreasing MABP. Mean (±SD) TF gain was 0.8 (±0.3)%/mmHg. Impaired CAR was identified in 1 and 5 patient(s) during drug-related hypotension and normal to raised MABP, respectively. Suppressed aEEG was observed up to 60 min after propofol. Conclusions: Drug-related hypotension and decreased cerebral activity after intubation with low propofol doses in preterm neonates were observed, without evidence of cerebral ischemic hypoxia. CAR remained intact during drug-related hypotension in 95.5% of patients. Cerebral monitoring including CAR clarifies the cerebral impact of MABP fluctuations.

Original languageEnglish (US)
Pages (from-to)719-725
Number of pages7
JournalPediatric Research
Volume84
Issue number5
DOIs
StatePublished - Nov 1 2018
Externally publishedYes

All Science Journal Classification (ASJC) codes

  • Pediatrics, Perinatology, and Child Health

Fingerprint Dive into the research topics of 'Cerebral autoregulation and activity after propofol for endotracheal intubation in preterm neonates'. Together they form a unique fingerprint.

Cite this