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

Resultado de la investigación: Contribución a una revistaArtículorevisión exhaustiva

8 Citas (Scopus)

Resumen

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.

Idioma originalInglés estadounidense
Páginas (desde-hasta)719-725
Número de páginas7
PublicaciónPediatric Research
Volumen84
N.º5
DOI
EstadoPublicada - nov 1 2018
Publicado de forma externa

All Science Journal Classification (ASJC) codes

  • Pediatría, perinaltología y salud infantil

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