Cerebrovascular autoregulation in preterm fetal growth restricted neonates

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 (b...

Full description

Autores:
Tipo de recurso:
Fecha de publicación:
2019
Institución:
Universidad del Rosario
Repositorio:
Repositorio EdocUR - U. Rosario
Idioma:
eng
OAI Identifier:
oai:repository.urosario.edu.co:10336/22755
Acceso en línea:
https://doi.org/10.1136/archdischild-2017-313712
https://repository.urosario.edu.co/handle/10336/22755
Palabra clave:
Article
Autoregulation
Birth weight
Blood pressure
Blood pressure variability
Brain blood vessel
Case control study
Controlled study
Female
Gestational age
Human
Intrauterine growth retardation
Major clinical study
Male
Mean arterial pressure
Neonatal intensive care unit
Netherlands
Newborn
Oximetry
Oxygen saturation
Patient selection
Premature labor
Prematurity
Priority journal
Retrospective study
Blood pressure measurement
Brain circulation
Devices
Homeostasis
Intrauterine growth retardation
Near infrared spectroscopy
Oxygen consumption
Pathophysiology
Physiologic monitoring
Physiology
Procedures
Prognosis
Statistics and numerical data
Birth Weight
Blood Pressure Determination
Cerebrovascular Circulation
Female
Fetal Growth Retardation
Gestational Age
Homeostasis
Humans
Male
Netherlands
Oxygen Consumption
Prognosis
Cerebrovascular autoregulation
Fetal growth restriction (FGR)
Intrauterine growth restriction (IUGR)
Near-infrared spectroscopy (NIRS)
Prematurity
Premature
Near-Infrared
Neonatal
Newborn
Physiologic
Infant
Infant
Intensive Care Units
Monitoring
Spectroscopy
Rights
License
Abierto (Texto Completo)
Description
Summary: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 less than 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(s) (or their employer(s)) 2019.