Posthemorrhagic ventricular dilatation late intervention threshold and associated brain injury.

Autor: Valverde E; Department of Neonatology, La Paz University Hospital, Madrid, Spain.; NeNe Foundation, Madrid, Spain.; Hospital La Paz Institute for Health Research-IdiPAZ, Madrid, Spain., Ybarra M; Department of Neonatology, La Paz University Hospital, Madrid, Spain., Benito AV; Department of Neonatology, La Paz University Hospital, Madrid, Spain., Bravo MC; Department of Neonatology, La Paz University Hospital, Madrid, Spain.; Hospital La Paz Institute for Health Research-IdiPAZ, Madrid, Spain., Pellicer A; Department of Neonatology, La Paz University Hospital, Madrid, Spain.; Hospital La Paz Institute for Health Research-IdiPAZ, Madrid, Spain.
Jazyk: angličtina
Zdroj: PloS one [PLoS One] 2022 Oct 27; Vol. 17 (10), pp. e0276446. Date of Electronic Publication: 2022 Oct 27 (Print Publication: 2022).
DOI: 10.1371/journal.pone.0276446
Abstrakt: Objective: To systematically assess white matter injury (WMI) in preterm infants with posthemorrhagic ventricular dilatation (PHVD) using a high-threshold intervention strategy.
Study Design: This retrospective analysis included 85 preterm infants (≤34 weeks of gestation) with grade 2-3 germinal matrix-intraventricular hemorrhage. Cranial ultrasound (cUS) scans were assessed for WMI and ventricular width and shape. Forty-eight infants developed PHVD, 21 of whom (intervention group) underwent cerebrospinal fluid drainage according to a predefined threshold (ventricular index ≥p97+4 mm or anterior horn width >10 mm, and the presence of frontal horn ballooning). The other 27 infants underwent a conservative approach (non-intervention group). The two PHVD groups were compared regarding ventricular width at two stages: the worst cUS for the non-intervention group (scans showing the largest ventricular measurements) versus pre-intervention cUS in the intervention group, and at term equivalent age. WMI was classified as normal/mild, moderate and severe.
Results: The intervention group showed significantly larger ventricular index, anterior horn width and thalamo-occipital diameter than the non-intervention group at the two timepoints. Moderate and severe WMI were more frequent in the infants with PHVD (p<0.001), regardless of management (intervention or conservative management). There was a linear relationship between the severity of PHVD and WMI (p<0.001).
Conclusions: Preterm infants with PHVD who undergo a high-threshold intervention strategy associate an increased risk of WMI.
Competing Interests: The authors have declared that no competing interest exist.
Databáze: MEDLINE
Externí odkaz:
Nepřihlášeným uživatelům se plný text nezobrazuje