Early arterial pressure monitoring and term-equivalent age MRI findings in very preterm infants
| Autor: | Sylviane Hanquinet, Alain Beuchée, Riccardo Pfister, Céline Habre, Roberta Butticci, Francisca Barcos-Munoz, Olivier Baud, Alfredo Hernandez |
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| Přispěvatelé: | University of Geneva [Switzerland], Laboratoire Traitement du Signal et de l'Image (LTSI), Université de Rennes 1 (UR1), Université de Rennes (UNIV-RENNES)-Université de Rennes (UNIV-RENNES)-Institut National de la Santé et de la Recherche Médicale (INSERM), CHU Pontchaillou [Rennes], Maladies neurodéveloppementales et neurovasculaires (NeuroDiderot (UMR_S_1141 / U1141)), Institut National de la Santé et de la Recherche Médicale (INSERM)-Université de Paris (UP), Department of Pediatrics, University Hospitals, Geneva, Institut National de la Santé et de la Recherche Médicale (INSERM)-Université Paris Cité (UPC), Université de Genève = University of Geneva (UNIGE), Université de Rennes (UR)-Institut National de la Santé et de la Recherche Médicale (INSERM), Institut National de la Santé et de la Recherche Médicale (INSERM)-Université Paris Cité (UPCité) |
| Jazyk: | angličtina |
| Rok vydání: | 2021 |
| Předmět: |
Inotrope
medicine.medical_specialty Gestational Age Brain damage Infant Premature Diseases Logistic regression 03 medical and health sciences 0302 clinical medicine 030225 pediatrics Internal medicine medicine.artery medicine Birth Weight Humans Arterial Pressure Prospective Studies Fetal Growth Retardation business.industry Infant Newborn Gestational age Brain Infant Umbilical artery medicine.disease Magnetic Resonance Imaging 3. Good health Very preterm Intraventricular hemorrhage Blood pressure Brain Injuries Pediatrics Perinatology and Child Health Cardiology Female [SDV.IB]Life Sciences [q-bio]/Bioengineering medicine.symptom business 030217 neurology & neurosurgery Infant Premature |
| Zdroj: | Pediatric Research Pediatric Research, Nature Publishing Group, 2021, ⟨10.1038/s41390-021-01839-2⟩ Pediatric Research, 2022, 92 (3), pp.822-828. ⟨10.1038/s41390-021-01839-2⟩ |
| ISSN: | 0031-3998 1530-0447 |
| Popis: | International audience; Introduction Variability of arterial blood pressure (ABP) has been associated with intraventricular hemorrhage in very preterm neonates (VPT) and may predict other brain lesions assessed at term-equivalent of age (TEA). Methods This was a prospective single-center study including VPT with early invasive continuous ABP monitoring and assessed at TEA using brain magnetic resonance imaging (TEA-MRI). The association between early mean ABP (MABP) and TEA-MRI findings was modeled by multivariate logistic regression analysis using covariates selected by the LASSO method. Results Among 99 VPT, the LASSO procedure selected consecutive periods of lowest MABP of 30 min on day 1 (d1) and 10 min on day 2 (d2) as the most relevant durations to predict TEA-MRI findings (OR [95% CI], 1.11 [1.02-1.23], p = 0.03 and 1.13 [1.01-1.27], p = 0.03, respectively). ROC curve analysis showed optimal thresholds at 30.25 mmHg on d1 and 33.25 mmHg on d2. This significant association persisted after adjustment with covariates including birthweight, gestational age, sex, and inotrope exposure. Final models selected by LASSO included the decile of the birthweight and lowest MABP for 30 min on d1 and 10 min on d2, for which the areas under the ROC curve were 74% and 75%, respectively. Conclusion Early continuous ABP monitoring may predict brain TEA-MRI findings in VPT. Impact Early arterial blood pressure monitoring may contribute to predicting brain damage upon MRI at term-equivalent of age for infants born very preterm. Careful blood pressure continuous monitoring in very preterm infants may identify infants at risk of long-term brain damage. Umbilical artery catheterization provides the best option for continuously monitoring arterial blood pressure in very preterm infants. |
| Databáze: | OpenAIRE |
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