Cerebrovascular autoregulation in preterm fetal growth restricted neonates

Título traducido de la contribución: Autoregulación Cerebrovascular en Neonatos Prematuros con Crecimiento Fetal Restringido

Emily Cohen, Willem Baerts, Alexander Caicedo Dorado, Gunnar Naulers, Frank van Bel, Petra M A Lemmers

Resultado de la investigación: Contribución a RevistaArtículo

Resumen

Objetivo: Investigar el efecto del crecimiento fetal restringido (FGR) en la autoregulación cerebrovascular en niños prematuros durante los 3 primeros días de vida. Diseño: Estudio Caso-Control. Ubicación: Unidad de Cuidados Intensivos Neonatales del Hospital de Niños de Wilhelmina, Países bajos. Pacientes: 57 niños prematuros con FGR (Peso al nacer > 10mo percentile) y 57 niños prematuros con peso apropiado para su edad gestacional (AGA) (peso al nacer entre 20avo-80avo percentil), emparejados por sexo, edad gestacional. y soporte respiratorio y en presión arterial. Métodos: Se calculo la correlación entre las mediciones continuas de presión arterial y oxigenación cerebral para generar el indice de oxigenación cerebral (COx). La media del COx fue calculada cada día. El porcentaje de tiempo con fallas en la autoregulacion cerebral también se calculo (COx < 0.5). REsultados: neonatos con FGR tienen valores mas altos de COx qu elos reportados fpor el grupo de control en el segundo día (0.15 (95% CI 0.11 a 0.18) vs 0.09 (95% CI 0.06 a 0.13), p=0.029), y en el tercer día (0.17 (95% CI 0.13 a 0.20) vs 0.09 (95% CI 0.06 a 0.12), p=0.003). Los neonatos con FGR presentan mas tiempo con fallas en la autoregulación cerebral (COx > 0.5) que los sujetos de control en el 2ndo día despues de nacer (19% (95% CI 16% a 22%) vs 14% (95% CI 12% a 17%), p=0.035) y el 3ro (20% (95% CI 17% a 24%) vs 15% (95% CI 12% a 18%), p=0.016).Conclusiones: niños prematuros con FGR presentan fallas en su autoregulación cerebral más frecuentemente que los sujetos de control AGA en el segundo y tercer día de vida, lo cual los predispone a lesiones cerebrales. Se requiere de más estudios para determinar si esta discapacidad se extiende más allá de los primeros días de vida, y si esta relacionada con un pobre desarrollo neuronal.
Idioma originalEnglish (US)
Páginas (desde-hasta)1
Número de páginas6
PublicaciónArchives of Disease in Childhood: Fetal and Neonatal Edition
DOI
EstadoPublished - oct 2018

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Cohen, Emily ; Baerts, Willem ; Caicedo Dorado, Alexander ; Naulers, Gunnar ; van Bel, Frank ; Lemmers, Petra M A. / Cerebrovascular autoregulation in preterm fetal growth restricted neonates. En: Archives of Disease in Childhood: Fetal and Neonatal Edition. 2018 ; pp. 1.
@article{bc55e40ae9aa420b9a539d08f8aa7ff0,
title = "Cerebrovascular autoregulation in preterm fetal growth restricted neonates",
abstract = "Objective: To investigate the effect of fetal growth restriction (FGR) on cerebrovascular autoregulation in preterm neonates during the first 3 days of life. Design: Case–control study. Setting: Neonatal intensive care unit of the Wilhelmina Children’s Hospital, The Netherlands. Patients: 57 FGR (birth weight <10th percentile) and 57 appropriate for gestational age (AGA) (birth weight 20th–80th percentiles) preterm neonates, matched for gender, gestational age, respiratory and blood pressure support. Methods: The correlation between continuously measured mean arterial blood pressure and regional cerebral oxygen saturation was calculated to generate the cerebral oximetry index (COx). Mean COx was calculated for each patient for each postnatal day. The percentage of time with impaired autoregulation (COx>0.5) was also calculated. Results: FGR neonates had higher mean COx values than their AGA peers on day 2 (0.15 (95{\%} CI 0.11 to 0.18) vs 0.09 (95{\%} CI 0.06 to 0.13), p=0.029) and day 3 (0.17 (95{\%} CI 0.13 to 0.20) vs 0.09 (95{\%} CI 0.06 to 0.12), p=0.003) of life. FGR neonates spent more time with impaired autoregulation (COx value >0.5) than controls on postnatal day 2 (19{\%} (95{\%} CI 16{\%} to 22{\%}) vs 14{\%} (95{\%} CI 12{\%} to 17{\%}), p=0.035) and day 3 (20{\%} (95{\%} CI 17{\%} to 24{\%}) vs 15{\%} (95{\%} CI 12{\%} to 18{\%}), p=0.016). Conclusion: FGR preterm neonates more frequently display impaired cerebrovascular autoregulation compared with AGA peers on days 2 and 3 of life which may predispose them to brain injury. Further studies are required to investigate whether this impairment persists beyond the first few days of life and whether this impairment is linked to poor neurodevelopmental outcome.",
author = "Emily Cohen and Willem Baerts and {Caicedo Dorado}, Alexander and Gunnar Naulers and {van Bel}, Frank and Lemmers, {Petra M A}",
year = "2018",
month = "10",
doi = "10.1136/archdischild-2017-313712",
language = "English (US)",
pages = "1",
journal = "Archives of Disease in Childhood: Fetal and Neonatal Edition",
issn = "1359-2998",
publisher = "BMJ Publishing Group",

}

Cerebrovascular autoregulation in preterm fetal growth restricted neonates. / Cohen, Emily; Baerts, Willem; Caicedo Dorado, Alexander; Naulers, Gunnar; van Bel, Frank; Lemmers, Petra M A.

En: Archives of Disease in Childhood: Fetal and Neonatal Edition, 10.2018, p. 1.

Resultado de la investigación: Contribución a RevistaArtículo

TY - JOUR

T1 - Cerebrovascular autoregulation in preterm fetal growth restricted neonates

AU - Cohen, Emily

AU - Baerts, Willem

AU - Caicedo Dorado, Alexander

AU - Naulers, Gunnar

AU - van Bel, Frank

AU - Lemmers, Petra M A

PY - 2018/10

Y1 - 2018/10

N2 - Objective: To investigate the effect of fetal growth restriction (FGR) on cerebrovascular autoregulation in preterm neonates during the first 3 days of life. Design: Case–control study. Setting: Neonatal intensive care unit of the Wilhelmina Children’s Hospital, The Netherlands. Patients: 57 FGR (birth weight <10th percentile) and 57 appropriate for gestational age (AGA) (birth weight 20th–80th percentiles) preterm neonates, matched for gender, gestational age, respiratory and blood pressure support. Methods: The correlation between continuously measured mean arterial blood pressure and regional cerebral oxygen saturation was calculated to generate the cerebral oximetry index (COx). Mean COx was calculated for each patient for each postnatal day. The percentage of time with impaired autoregulation (COx>0.5) was also calculated. Results: FGR neonates had higher mean COx values than their AGA peers on day 2 (0.15 (95% CI 0.11 to 0.18) vs 0.09 (95% CI 0.06 to 0.13), p=0.029) and day 3 (0.17 (95% CI 0.13 to 0.20) vs 0.09 (95% CI 0.06 to 0.12), p=0.003) of life. FGR neonates spent more time with impaired autoregulation (COx value >0.5) than controls on postnatal day 2 (19% (95% CI 16% to 22%) vs 14% (95% CI 12% to 17%), p=0.035) and day 3 (20% (95% CI 17% to 24%) vs 15% (95% CI 12% to 18%), p=0.016). Conclusion: FGR preterm neonates more frequently display impaired cerebrovascular autoregulation compared with AGA peers on days 2 and 3 of life which may predispose them to brain injury. Further studies are required to investigate whether this impairment persists beyond the first few days of life and whether this impairment is linked to poor neurodevelopmental outcome.

AB - Objective: To investigate the effect of fetal growth restriction (FGR) on cerebrovascular autoregulation in preterm neonates during the first 3 days of life. Design: Case–control study. Setting: Neonatal intensive care unit of the Wilhelmina Children’s Hospital, The Netherlands. Patients: 57 FGR (birth weight <10th percentile) and 57 appropriate for gestational age (AGA) (birth weight 20th–80th percentiles) preterm neonates, matched for gender, gestational age, respiratory and blood pressure support. Methods: The correlation between continuously measured mean arterial blood pressure and regional cerebral oxygen saturation was calculated to generate the cerebral oximetry index (COx). Mean COx was calculated for each patient for each postnatal day. The percentage of time with impaired autoregulation (COx>0.5) was also calculated. Results: FGR neonates had higher mean COx values than their AGA peers on day 2 (0.15 (95% CI 0.11 to 0.18) vs 0.09 (95% CI 0.06 to 0.13), p=0.029) and day 3 (0.17 (95% CI 0.13 to 0.20) vs 0.09 (95% CI 0.06 to 0.12), p=0.003) of life. FGR neonates spent more time with impaired autoregulation (COx value >0.5) than controls on postnatal day 2 (19% (95% CI 16% to 22%) vs 14% (95% CI 12% to 17%), p=0.035) and day 3 (20% (95% CI 17% to 24%) vs 15% (95% CI 12% to 18%), p=0.016). Conclusion: FGR preterm neonates more frequently display impaired cerebrovascular autoregulation compared with AGA peers on days 2 and 3 of life which may predispose them to brain injury. Further studies are required to investigate whether this impairment persists beyond the first few days of life and whether this impairment is linked to poor neurodevelopmental outcome.

U2 - 10.1136/archdischild-2017-313712

DO - 10.1136/archdischild-2017-313712

M3 - Article

SP - 1

JO - Archives of Disease in Childhood: Fetal and Neonatal Edition

JF - Archives of Disease in Childhood: Fetal and Neonatal Edition

SN - 1359-2998

ER -