Fleur A Camfferman1, Robbin de Goederen2, Paul Govaert3,4,5,6, Jeroen Dudink4,7, Frank van Bel7, Adelina Pellicer8, Filip Cools3. 1. Department of Neonatology, Universitair Ziekenhuis Brussel, Vrije Universiteit Brussel, Brussels, Belgium. Fleur.Camfferman@uzbrussel.be. 2. Dutch Craniofacial Centre Rotterdam, Department of Plastic and Reconstructive Surgery, Erasmus Medical Center University, Rotterdam, The Netherlands. 3. Department of Neonatology, Universitair Ziekenhuis Brussel, Vrije Universiteit Brussel, Brussels, Belgium. 4. Department of Neonatology, Erasmus Medical Center University, Sophia Children's Hospital, Rotterdam, The Netherlands. 5. Department of Neonatology, ZNA Middelheim, Antwerp, Belgium. 6. Department of Rehabilitation and Physical Therapy, Gent University Hospital, Gent, Belgium. 7. Department of Neonatology, University Medical Center Utrecht, Wilhelmina Children's Hospital, Utrecht, The Netherlands. 8. Department of Neonatology, La Paz University Hospital, Madrid, Spain.
Abstract
INTRODUCTION: Very and extremely preterm infants frequently have brain injury-related long-term neurodevelopmental problems. Altered perfusion, for example, seen in the context of a hemodynamically significant patent ductus arteriosus (PDA), has been linked to injury of the immature brain. However, a direct relation with outcome has not been reviewed systematically. METHODS: A systematic review was conducted to provide an overview of the value of different cerebral arterial blood flow parameters assessed by Doppler ultrasound, in relation to brain injury, to predict long-term neurodevelopmental outcome in preterm infants. RESULTS: In total, 23 studies were included. Because of heterogeneity of studies, a meta-analysis of results was not possible. All included studies on resistance index (RI) showed significantly higher values in subjects with a hemodynamically significant PDA. However, absolute differences in RI values were small. Studies using Doppler parameters to predict brain injury and long-term neurodevelopmental outcome were inconsistent. DISCUSSION: There is no clear evidence to support the routine determination of RI or other Doppler parameters in the cerebral arteries to predict brain injury and long-term neurodevelopmental outcome in the preterm infant. However, there is evidence that elevated RI can point to the presence of a hemodynamically significant PDA.
INTRODUCTION: Very and extremely preterm infants frequently have brain injury-related long-term neurodevelopmental problems. Altered perfusion, for example, seen in the context of a hemodynamically significant patent ductus arteriosus (PDA), has been linked to injury of the immature brain. However, a direct relation with outcome has not been reviewed systematically. METHODS: A systematic review was conducted to provide an overview of the value of different cerebral arterial blood flow parameters assessed by Doppler ultrasound, in relation to brain injury, to predict long-term neurodevelopmental outcome in preterm infants. RESULTS: In total, 23 studies were included. Because of heterogeneity of studies, a meta-analysis of results was not possible. All included studies on resistance index (RI) showed significantly higher values in subjects with a hemodynamically significant PDA. However, absolute differences in RI values were small. Studies using Doppler parameters to predict brain injury and long-term neurodevelopmental outcome were inconsistent. DISCUSSION: There is no clear evidence to support the routine determination of RI or other Doppler parameters in the cerebral arteries to predict brain injury and long-term neurodevelopmental outcome in the preterm infant. However, there is evidence that elevated RI can point to the presence of a hemodynamically significant PDA.
Authors: Thomas Alderliesten; Petra M A Lemmers; Janneke J M Smarius; René E van de Vosse; Willem Baerts; Frank van Bel Journal: J Pediatr Date: 2012-11-06 Impact factor: 4.406
Authors: Flora Y Wong; Terence S Leung; Topun Austin; Malcolm Wilkinson; Judith H Meek; John S Wyatt; Adrian M Walker Journal: Pediatrics Date: 2008-02-04 Impact factor: 7.124
Authors: Cristine Sortica da Costa; Marek Czosnyka; Peter Smielewski; Subhabrata Mitra; Gordon N Stevenson; Topun Austin Journal: J Pediatr Date: 2015-04-17 Impact factor: 4.406
Authors: Sophie A Costerus; Anna J Kortenbout; Hendrik J Vos; Paul Govaert; Dick Tibboel; René M H Wijnen; Nico de Jong; Johan G Bosch; Jurgen C de Graaff Journal: Front Pediatr Date: 2021-03-22 Impact factor: 3.418
Authors: Rachel L Leon; Eric B Ortigoza; Noorjahan Ali; Dimitrios Angelis; Joshua S Wolovits; Lina F Chalak Journal: Front Pediatr Date: 2022-01-11 Impact factor: 3.418