Elise A Verhagen1, Liesbeth A Hummel2, Arend F Bos2, Elisabeth M W Kooi2. 1. Division of Neonatology, Beatrix Children's Hospital, University of Groningen, University Medical Center Groningen, The Netherlands. Electronic address: e.a.verhagen@umcg.nl. 2. Division of Neonatology, Beatrix Children's Hospital, University of Groningen, University Medical Center Groningen, The Netherlands.
Abstract
OBJECTIVE: Our aim was to explore clinical parameters that might predict the absence of cerebrovascular autoregulation (CAR) assessed by a negative relationship between mean arterial blood pressure (MABP) and fractional tissue oxygen extraction (FTOE) as measured by near-infared spectroscopy (NIRS) in preterm infants. METHODS: We included preterm infants (gestational age (GA) <32 weeks). Within 72 h after birth, we recorded the infants' NIRS parameters and MABP for a 24-h period. Fractional tissue oxygen extraction (FTOE) was calculated. For each infant we calculated Spearman rank (rho) correlations. A statistically significant negative correlation between MABP and FTOE indicated the absent CAR. We related the absent CAR to clinical parameters. RESULTS: Ten (40%) out of 25 infants (median GA 29.1 weeks, range 25.4-31.7, birth weight 1245 g, 560-1780) had a statistically significant negative correlation between MABP and FTOE (rho -0.432 to -0.156), suggesting the absence of CAR. None of the clinical variables predicted the absence of CAR. CONCLUSIONS: We were unable to predict the absence of CAR in terms of clinical variables. Nevertheless, we found a statistically significant negative correlation between MABP and FTOE using NIRS, suggesting the absence of CAR in almost half of the preterm infants studied. SIGNIFICANCE: NIRS could be a helpful tool to assess the presence or absence of CAR.
OBJECTIVE: Our aim was to explore clinical parameters that might predict the absence of cerebrovascular autoregulation (CAR) assessed by a negative relationship between mean arterial blood pressure (MABP) and fractional tissue oxygen extraction (FTOE) as measured by near-infared spectroscopy (NIRS) in preterm infants. METHODS: We included preterm infants (gestational age (GA) <32 weeks). Within 72 h after birth, we recorded the infants' NIRS parameters and MABP for a 24-h period. Fractional tissue oxygen extraction (FTOE) was calculated. For each infant we calculated Spearman rank (rho) correlations. A statistically significant negative correlation between MABP and FTOE indicated the absent CAR. We related the absent CAR to clinical parameters. RESULTS: Ten (40%) out of 25 infants (median GA 29.1 weeks, range 25.4-31.7, birth weight 1245 g, 560-1780) had a statistically significant negative correlation between MABP and FTOE (rho -0.432 to -0.156), suggesting the absence of CAR. None of the clinical variables predicted the absence of CAR. CONCLUSIONS: We were unable to predict the absence of CAR in terms of clinical variables. Nevertheless, we found a statistically significant negative correlation between MABP and FTOE using NIRS, suggesting the absence of CAR in almost half of the preterm infants studied. SIGNIFICANCE: NIRS could be a helpful tool to assess the presence or absence of CAR.
Authors: Trijntje E Schat; Michelle E van der Laan; Maarten Schurink; Jan B F Hulscher; Christian V Hulzebos; Arend F Bos; Elisabeth M W Kooi Journal: Pediatr Res Date: 2015-09-18 Impact factor: 3.756
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