Onset of brain injury in infants with prenatally diagnosed congenital heart disease

Autor: Arend F. Bos, Tjark Ebels, Catherina M. Bilardo, Marco Modestini, Rolf M. F. Berger, Mirthe J Mebius, Elisabeth M. W. Kooi, Martin C. J. Kneyber
Přispěvatelé: Reproductive Origins of Adult Health and Disease (ROAHD), Critical care, Anesthesiology, Peri-operative and Emergency medicine (CAPE), Cardiovascular Centre (CVC)
Jazyk: angličtina
Rok vydání: 2020
Předmět:
Male
Middle Cerebral Artery
NEAR-INFRARED SPECTROSCOPY
Heart disease
Pulmonology
FETAL CEREBROVASCULAR RESISTANCE
Cardiovascular Procedures
Maternal Health
Cerebral oxygen saturation
030204 cardiovascular system & hematology
CEREBRAL OXYGEN-SATURATION
Umbilical Arteries
Families
0302 clinical medicine
Pregnancy
Prenatal Diagnosis
Medicine and Health Sciences
Morphogenesis
Brain Damage
Children
Multidisciplinary
NEWBORNS
Obstetrics and Gynecology
Thoracic Surgery
GENERAL MOVEMENTS
Congenital Heart Defects
Cardiac surgery
Chemistry
Neurology
Physical Sciences
Cardiology
Medicine
Female
medicine.symptom
Infants
Research Article
Chemical Elements
Heart Defects
Congenital
medicine.medical_specialty
Cardiac Surgery
Science
Surgical and Invasive Medical Procedures
Gestational Age
Brain damage
03 medical and health sciences
NEURODEVELOPMENTAL OUTCOMES
FETUSES
medicine.artery
Internal medicine
PRETERM INFANTS
Medical Hypoxia
medicine
Congenital Disorders
Humans
Birth Defects
Fetus
BLOOD-FLOW
business.industry
Infant
Newborn
Biology and Life Sciences
Infant
Umbilical artery
Ultrasonography
Doppler
Blood flow
medicine.disease
PREDICTIVE-VALUE
Additional research
Oxygen
Age Groups
Brain Injuries
People and Places
Birth
Women's Health
Population Groupings
business
030217 neurology & neurosurgery
Developmental Biology
Zdroj: PLoS ONE, 15(3):e0230414. PUBLIC LIBRARY SCIENCE
PLoS ONE
PLoS ONE, Vol 15, Iss 3, p e0230414 (2020)
ISSN: 1932-6203
DOI: 10.1371/journal.pone.0230414
Popis: BackgroundThe exact onset of brain injury in infants with congenital heart disease (CHD) is unknown. Our aim was, therefore, to assess the association between prenatal Doppler flow patterns, postnatal cerebral oxygenation and short-term neurological outcome.MethodsPrenatally, we measured pulsatility indices of the middle cerebral (MCA-PI) and umbilical artery (UA-PI) and calculated cerebroplacental ratio (CPR). After birth, cerebral oxygen saturation (r(c)SO(2)) and fractional tissue oxygen extraction (FTOE) were assessed during the first 3 days after birth, and during and for 24 hours after every surgical procedure within the first 3 months after birth. Neurological outcome was determined preoperatively and at 3 months of age by assessing general movements and calculating the Motor Optimality Score (MOS).ResultsThirty-six infants were included. MOS at 3 months was associated with MCA-PI (rho 0.41, P = 0.04), UA-PI (rho -0.39, P = 0.047, and CPR (rho 0.50, P = 0.01). Infants with abnormal MOS had lower MCA-PI (P = 0.02) and CPR (P = 0.01) and higher UA-PI at the last measurement (P = 0.03) before birth. In infants with abnormal MOS, r(c)SO(2) tended to be lower during the first 3 days after birth, and FTOE was significantly higher on the second day after birth (P = 0.04). Intraoperative and postoperative r(c)SO(2) and FTOE were not associated with short-term neurological outcome.ConclusionIn infants with prenatally diagnosed CHD, the prenatal period may play an important role in developmental outcome. Additional research is needed to clarify the relationship between preoperative, intra-operative and postoperative cerebral oxygenation and developmental outcome in infants with prenatally diagnosed CHD.
Databáze: OpenAIRE
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