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Autoregulation preterm

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https://www.readbyqxmd.com/read/28639837/measuring-cerebrovascular-autoregulation-in-preterm-infants-using-near-infrared-spectroscopy-an-overview-of-the-literature
#1
Elisabeth M W Kooi, Elise A Verhagen, Jan Willem J Elting, Marek Czosnyka, Topun Austin, Flora Y Wong, Marcel J H Aries
The preterm born infant's ability to regulate its cerebral blood flow (CBF) is crucial in preventing secondary ischemic and hemorrhagic damage in the developing brain. The relationship between arterial blood pressure (ABP) and CBF estimates, such as regional cerebral oxygenation as measured by near-infrared spectroscopy (NIRS), is an attractive option for continuous non-invasive assessment of cerebrovascular autoregulation. Areas covered: The authors performed a literature search to provide an overview of the current literature on various current clinical practices and methods to measure cerebrovascular autoregulation in the preterm infant by NIRS...
June 22, 2017: Expert Review of Neurotherapeutics
https://www.readbyqxmd.com/read/28421173/cerebral-autoregulation-brain-injury-and-the-transitioning-premature-infant
#2
REVIEW
Zachary A Vesoulis, Amit M Mathur
Improvements in clinical management of the preterm infant have reduced the rates of the two most common forms of brain injury, such as severe intraventricular hemorrhage and white matter injury, both of which are contributory factors in the development of cerebral palsy. Nonetheless, they remain a persistent challenge and are associated with a significant increase in the risk of adverse neurodevelopment outcomes. Repeated episodes of ischemia-reperfusion represent a common pathway for both forms of injury, arising from discordance between systemic blood flow and the innate regulation of cerebral blood flow in the germinal matrix and periventricular white matter...
2017: Frontiers in Pediatrics
https://www.readbyqxmd.com/read/28384837/the-impact-of-integrated-evaluation-of-hemodynamics-on-management-of-preterm-infants-with-late-onset-compromised-systemic-circulation
#3
Reem Amer, Reem Kalash, Mary M Seshia, Yasser N Elsayed
Objectives To study the impact of integrated evaluation of hemodynamics (IEH), using targeted neonatal echocardiography (TNE), cerebral regional tissue oxygenation (crRTO), and fractional oxygen extraction (FOE), using near-infrared spectroscopy (NIRS) on the management of infants with late-onset compromised systemic circulation (LCSC), and evaluation of the hemodynamic characteristics. Study Design Retrospective cohort study comparing infants with LCSC who underwent IEH (April 2014 to May 2016) with an earlier EPOCH who did not undergo IEH (January 2012 to March 2014)...
April 6, 2017: American Journal of Perinatology
https://www.readbyqxmd.com/read/28211916/role-of-endothelial-nitric-oxide-synthase-and-endothelin-1-polymorphism-genes-with-the-pathogenesis-of-intraventricular-hemorrhage-in-preterm-infants
#4
Dawid Szpecht, Janusz Gadzinowski, Agnieszka Seremak-Mrozikiewicz, Grażyna Kurzawińska, Marta Szymankiewicz
In the pathogenesis of neonatal intraventricular hemorrhage (IVH) in preterm infants, an important role is played by changes in venous and arterial cerebral flows. It has been shown that the ability of autoregulation of cerebral flows in response to variations in arterial blood pressure in preterm infants is impaired. This impaired autoregulation causes an increased risk of germinal matrix rupture and IVH occurrence. We examined three polymorphisms of genes, related to regulation of blood flow, for an association with IVH in 100 preterm infants born from singleton pregnancy, before 32 + 0 weeks of gestation, exposed to antenatal steroids therapy, and without congenital abnormalities...
February 13, 2017: Scientific Reports
https://www.readbyqxmd.com/read/28009319/-ultrasound-monitoring-of-central-and-cerebral-hemodynamics-during-the-treatment-of-arterial-hypotension-in-preterm-infants
#5
A Zakrevskyy, O Karapetyan, V Agashkov, K Kosenko
The purpose of the study was to evaluate and identify patterns of changes in central and cerebral hemodynamics in neonates with low and extremely low birth weight and birth asphyxia, in order to achieve the early diagnosis of disorders of the central hemodynamics and autoregulation of cerebral blood flow, for timely fluid correction and inotropic therapy. Observation data on 44 preterm infants who were treated at the Kharkiv City Perinatal Centre and Regional Children's Clinical Hospital №1 of Kharkiv has been analyzed...
November 2016: Georgian Medical News
https://www.readbyqxmd.com/read/27924521/effects-of-different-surfactant-administrations-on-cerebral-autoregulation-in-preterm-infants-with-respiratory-distress-syndrome
#6
RANDOMIZED CONTROLLED TRIAL
Xu-Fang Li, Ting-Ting Cheng, Rui-Lian Guan, Hong Liang, Wei-Neng Lu, Jing-Hua Zhang, Mei-Yi Liu, Xin Yu, Jun Liang, Li Sun, Lian Zhang
To treat respiratory distress syndrome, surfactant is currently delivered via less invasive surfactant administration (LISA) or INtubation SURfactant Extubation (INSURE). The aim of this study was to compare the effect of the two delivery methods of surfactant on cerebral autoregulation. Near infrared spectroscopy monitoring was carried out to detect cerebral oxygen saturation (ScO2), and the mean arterial blood pressure (MABP) was simultaneously recorded. Of 44 preterm infants included, the surfactant was administrated to 22 via LISA and 22 via INSURE...
December 2016: Journal of Huazhong University of Science and Technology. Medical Sciences
https://www.readbyqxmd.com/read/27603562/near-infrared-spectroscopy-for-detection-of-a-significant-patent-ductus-arteriosus
#7
Valerie Y Chock, Laura A Rose, Jeanet V Mante, Rajesh Punn
BACKGROUND: Near-infrared spectroscopy (NIRS) may assist with characterization of a hemodynamically significant patent ductus arteriosus (hsPDA) by measuring cerebral and renal saturation (Csat and Rsat) levels. We hypothesized that Csat and Rsat in preterm infants with an hsPDA would be decreased compared to those with no PDA or nonsignificant PDA. METHODS: This non a-priori designed study retrospectively investigated clinical and ECHO characteristics of preterm infants <29 wk gestation who underwent routine NIRS monitoring...
November 2016: Pediatric Research
https://www.readbyqxmd.com/read/27104347/the-effect-of-maternal-antihypertensive-drugs-on-the-cerebral-renal-and-splanchnic-tissue-oxygen-extraction-of-preterm-neonates
#8
Anne E Richter, Trijntje E Schat, Koenraad N J A Van Braeckel, Sicco A Scherjon, Arend F Bos, Elisabeth M W Kooi
BACKGROUND: Drugs with antihypertensive action are frequently used in obstetrics for the treatment of preeclampsia (labetalol) and tocolysis (nifedipine) or for neuroprotection (MgSO4), and may affect the hemodynamics of preterm born neonates. OBJECTIVE: The aim of this study was to assess whether maternal antihypertensive drugs affect multisite oxygenation levels of the neonate. METHODS: Eighty preterm neonates of ≤32 weeks of gestational age were monitored using near-infrared spectroscopy...
2016: Neonatology
https://www.readbyqxmd.com/read/26782253/can-the-assessment-of-spontaneous-oscillations-by-near-infrared-spectrophotometry-predict-neurological-outcome-of-preterm-infants
#9
André Stammwitz, Kurt von Siebenthal, Hans U Bucher, Martin Wolf
The aim was to assess the correlation between cerebral autoregulation and outcome. Included were 31 preterm infants, gestational age 26 1/7 to 32 2/7 and <24 h life. Coherence between cerebral total haemoglobin (tHb) or oxygenation index (OI) measured by near-infrared spectrophotometry (NIRS) and systemic heart rate (HR) or arterial blood pressure (MAP) was calculated as a measure of autoregulation. In contrast to previous studies, low coherences in the first 24 h were significantly associated with intraventricular haemorrhage, death or abnormal neurodevelopmental outcome at 18 months or later...
2016: Advances in Experimental Medicine and Biology
https://www.readbyqxmd.com/read/26782252/characterizing-fluctuations-of-arterial-and-cerebral-tissue-oxygenation-in-preterm-neonates-by-means-of-data-analysis-techniques-for-nonlinear-dynamical-systems
#10
Stefan Kleiser, Marcin Pastewski, Tharindi Hapuarachchi, Cornelia Hagmann, Jean-Claude Fauchère, Ilias Tachtsidis, Martin Wolf, Felix Scholkmann
The cerebral autoregulatory state as well as fluctuations in arterial (SpO2) and cerebral tissue oxygen saturation (StO2) are potentially new relevant clinical parameters in preterm neonates. The aim of the present study was to test the investigative capabilities of data analysis techniques for nonlinear dynamical systems, looking at fluctuations and their interdependence. StO2, SpO2 and the heart rate (HR) were measured on four preterm neonates for several hours. The fractional tissue oxygenation extraction (FTOE) was calculated...
2016: Advances in Experimental Medicine and Biology
https://www.readbyqxmd.com/read/26711678/dopamine-treatment-during-acute-hypoxia-is-neuroprotective-in-the-developing-sheep-brain
#11
N Brew, A Azhan, I den Heijer, M Boomgardt, G I Davies, I Nitsos, S L Miller, A M Walker, D W Walker, F Y Wong
Dopamine is often used to treat hypotension in preterm infants; these infants are at risk of developing brain injury due to impaired autoregulation and cerebral hypoperfusion. However the effects of dopamine on the immature brain under conditions of cerebral hypoxia are not known. We hypothesized that pretreatment with dopamine would protect the immature brain from injury caused by cerebral hypoxia. Preterm fetal sheep were used to determine the effects of intravenous dopamine on hypoxia-induced brain injury...
March 1, 2016: Neuroscience
https://www.readbyqxmd.com/read/26571222/a-novel-method-for-assessing-cerebral-autoregulation-in-preterm-infants-using-transfer-function-analysis
#12
Zachary A Vesoulis, Steve M Liao, Shamik B Trivedi, Nathalie El Ters, Amit M Mathur
BACKGROUND: Autoregulatory dysfunction is an important contributor to brain injury in premature infants, particularly intraventricular hemorrhage (IVH). The autoregulatory system acts as a filter that dampens the systemic blood flow to follow a normal cerebral perfusion profile. METHODS: Simultaneous arterial blood pressure and cerebral near-infrared spectroscopy (NIRS) data were collected from infants born before 28 wk estimated gestational age. The resulting data were preprocessed and then divided into nonoverlapping 20-min epochs...
March 2016: Pediatric Research
https://www.readbyqxmd.com/read/26539666/new-developments-in-cerebral-blood-flow-autoregulation-analysis-in-preterm-infants-a-mechanistic-approach
#13
Joan Riera, Fernando Cabañas, José Javier Serrano, Rosario Madero, Adelina Pellicer
BACKGROUND: Impaired autoregulation capacity implies that changes in cerebral perfusion follow changes in blood pressure; however, no analytical method has explored such a signal causality relationship in infants. We sought to develop a method to assess cerebral autoregulation from a mechanistic point of view and explored the predictive capacity of the method to classify infants at risk for adverse outcomes. METHODS: The partial directed coherence (PDC) method, which considers synchronicity and directionality of signal dependence across frequencies, was used to analyze the relationship between spontaneous changes in mean arterial pressure (MAP) and the cerebral tissue oxygenation index (TOI)...
March 2016: Pediatric Research
https://www.readbyqxmd.com/read/26539662/fast-doppler-as-a-novel-bedside-measure-of-cerebral-perfusion-in-preterm-infants
#14
Eric S Peeples, Edin Mehic, Pierre D Mourad, Sandra E Juul
BACKGROUND: Altered cerebral perfusion from impaired autoregulation may contribute to the morbidity and mortality associated with premature birth. We hypothesized that fast Doppler imaging could provide a reproducible bedside estimation of cerebral perfusion and autoregulation in preterm infants. METHODS: This is a prospective pilot study using fast Doppler ultrasound to assess blood flow velocity in the basal ganglia of 19 subjects born at 26-32 wk gestation...
February 2016: Pediatric Research
https://www.readbyqxmd.com/read/26383883/assessing-cerebrovascular-autoregulation-in-infants-with-necrotizing-enterocolitis-using-near-infrared-spectroscopy
#15
Trijntje E Schat, Michelle E van der Laan, Maarten Schurink, Jan B F Hulscher, Christian V Hulzebos, Arend F Bos, Elisabeth M W Kooi
BACKGROUND: We assessed cerebrovascular autoregulation (CAR) in preterm infants with definite necrotizing enterocolitis (NEC), Bell's stage 2 or 3, and infants without NEC, using near-infrared spectroscopy. We hypothesized that CAR would be more often impaired in infants with NEC compared with infants without NEC. METHODS: We measured cerebral regional tissue oxygen saturation, arterial oxygen saturation, and mean arterial blood pressure (MABP) during 48 h. We calculated the correlation between cerebral fractional tissue oxygen extraction and MABP for each patient...
January 2016: Pediatric Research
https://www.readbyqxmd.com/read/26381128/borderline-hypotension-how-does-it-influence-cerebral-regional-tissue-oxygenation-in-preterm-infants
#16
Corinna Binder-Heschl, Berndt Urlesberger, Bernhard Schwaberger, Martin Koestenberger, Gerhard Pichler
AIM: To monitor cerebral regional tissue oxygenation (crSO2) of preterm infants continuously and to analyze the influence of arterial hypotension on crSO2. METHODS: In this prospective, observational study crSO2, peripheral oxygen saturation (SpO2), heart rate (HR) and mean arterial blood pressure (MABP) were monitored continuously for 24 h, starting within the first 6 h after birth. Furthermore, cerebral fractional tissue oxygen extraction (cFTOE) was calculated...
2016: Journal of Maternal-fetal & Neonatal Medicine
https://www.readbyqxmd.com/read/25806662/cerebral-autoregulation-in-the-preterm-newborn-using-near-infrared-spectroscopy-a-comparison-of-time-domain-and-frequency-domain-analyses
#17
Vibeke R Eriksen, Gitte H Hahn, Gorm Greisen
The aim was to compare two conventional methods used to describe cerebral autoregulation (CA): frequency-domain analysis and time-domain analysis. We measured cerebral oxygenation (as a surrogate for cerebral blood flow) and mean arterial blood pressure (MAP) in 60 preterm infants. In the frequency domain, outcome variables were coherence and gain, whereas the cerebral oximetry index (COx) and the regression coefficient were the outcome variables in the time domain. Correlation between coherence and COx was poor...
March 2015: Journal of Biomedical Optics
https://www.readbyqxmd.com/read/25542161/impact-of-patent-ductus-arteriosus-and-subsequent-therapy-with-ibuprofen-on-the-release-of-s-100b-and-oxidative-stress-index-in-preterm-infants
#18
Nihat Demir, İbrahim Ece, Erdal Peker, Sultan Kaba, Lokman Ustyol, Ragıp Balahoroğlu, Oğuz Tuncer
BACKGROUND: Hemodynamically significant patent ductus arteriosus (hsPDA) leads to injury in tissues/organs by reducing perfusion of organs and causing oxidative stress. The purpose of this study was to evaluate the oxidant/antioxidant status in preterm infants with hsPDA by measuring the total antioxidant capacity and total oxidant status and to assess neuronal damage due to oxidant stress related to hsPDA. MATERIAL AND METHODS: This prospective study included 37 low-birth-weight infants with echocardiographically diagnosed hsPDA treated with oral ibuprofen and a control group of 40 infants without PDA...
2014: Medical Science Monitor: International Medical Journal of Experimental and Clinical Research
https://www.readbyqxmd.com/read/25266994/dopamine-therapy-is-associated-with-impaired-cerebral-autoregulation-in-preterm-infants
#19
Vibeke R Eriksen, Gitte H Hahn, Gorm Greisen
AIM: Hypotension is a common problem in newborn infants and is associated with increased mortality and morbidity. Dopamine is the most commonly used antihypotensive drug therapy, but has never been shown to improve neurological outcomes. This study tested our hypothesis that dopamine affects cerebral autoregulation (CA). METHODS: Near-infrared spectroscopy was used to measure the cerebral oxygenation index in 60 very preterm infants, and mean arterial blood pressure was monitored towards the end of their first day of life...
December 2014: Acta Paediatrica
https://www.readbyqxmd.com/read/25152257/cerebral-autoregulation-in-preterm-infants-how-to-measure-it-and-why-care
#20
EDITORIAL
Gorm Greisen
No abstract text is available yet for this article.
November 2014: Journal of Pediatrics
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