Hsu K.-H.a,b,c· Lin C.a,d· Lai M.-Y.a,b,c· Wu I-H.a,b· Chu J.-J.b,e· Chang Y.-S.b,e· Chiang M.-C.a,b,c· Lien R.a,b

Author affiliations

aDivision of Neonatology, Department of Pediatrics, Chang Gung Memorial Hospital Linkou Branch, Taoyuan, Taiwan
bSchool of Medicine, Chang Gung University, Taoyuan, Taiwan
cGraduate Institute of Clinical Medical Science, Chang Gung University, Taoyuan, Taiwan
dDepartment of Pediatrics, Chang Gung Memorial Hospital Keelung Branch, Keelung, Taiwan
eDivision of Cardiovascular Surgery, Chang Gung Memorial Hospital Linkou Branch, Taoyuan, Taiwan

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Article / Publication Details

First-Page Preview

Received: March 13, 2022
Accepted: July 04, 2022
Published online: August 18, 2022

Number of Print Pages: 9
Number of Figures: 3
Number of Tables: 3

ISSN: 1661-7800 (Print)
eISSN: 1661-7819 (Online)

For additional information: https://www.karger.com/NEO

Abstract

Introduction: Neurodevelopmental impairment is a growing concern for preterm infants who received surgical ligation of patent ductus arteriosus (PDA). We aimed to explore the cerebral hemodynamics during the critical period of PDA ligation. Methods: Very-low-birth-weight (VLBW) preterm infants who underwent PDA ligation were prospectively enrolled. Patients were monitored preoperatively and until 72 h post-ligation. Middle cerebral artery (MCA) flow, regional cerebral oxygen saturation (rcSO2), and cardiac output were measured through Doppler ultrasound, near-infrared spectroscopy, and electrical cardiometry, respectively. Using rcSO2 <55% indicating cerebral hypoxia, the duration (% of time) and burden (cumulative negative quantity of rsSO2 <55% × the period [minutes]) were estimated. An abnormal MCA was defined as an MCA flow of <10th percentile of flow velocity or >90th percentile of pulsatility or resistance index. Poor outcomes were defined as in-hospital death or neurologic disorders, either neuroimaging or functional abnormalities, upon discharge. Results: Thirty-two VLBW infants were examined, and 15 (46.9%) had poor outcomes. Infants with poor outcomes had significantly longer duration of cerebral hypoxia (5.4 [2.2–32.3] vs. 1.8 [0.4–5.6] %, p = 0.033) and worse hypoxic burden (2,118 [684–13,549] vs. 622 [88–1,669] %minutes, p = 0.027). In a linear mixed model, rcSO2 was positively correlated with arterial saturation (β 0.860, 95% CI: 0.649–1.070) and negatively correlated with abnormal MCA flow (β −5.287, 95% CI: −8.238 to −2.335). Conclusion: Longer duration of cerebral hypoxia and worse hypoxic burden post-ligation was associated with an increased risk of in-hospital mortality or neurologic disorders upon discharge in VLBW preterm infants.

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First-Page Preview

Received: March 13, 2022
Accepted: July 04, 2022
Published online: August 18, 2022

Number of Print Pages: 9
Number of Figures: 3
Number of Tables: 3

ISSN: 1661-7800 (Print)
eISSN: 1661-7819 (Online)

For additional information: https://www.karger.com/NEO

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