Cerebrovascular autoregulation in preterm fetal growth restricted neonates.
Arch Dis Child Fetal Neonatal Ed
; 104(5): F467-F472, 2019 Sep.
Article
em En
| MEDLINE
| ID: mdl-30355781
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.Palavras-chave
Texto completo:
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Base de dados:
MEDLINE
Assunto principal:
Consumo de Oxigênio
/
Determinação da Pressão Arterial
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Recém-Nascido Prematuro
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Circulação Cerebrovascular
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Retardo do Crescimento Fetal
/
Homeostase
Tipo de estudo:
Observational_studies
/
Prognostic_studies
Limite:
Female
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Humans
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Male
/
Newborn
País como assunto:
Europa
Idioma:
En
Ano de publicação:
2019
Tipo de documento:
Article