Abstract
Background: A hemodynamically important PDA is associated with increased morbidity and should be closed pharmacological or surgical. Studies showed that surgical closure contains a risk for adverse neurodevelopmental outcome.
Objective: To monitor cerebral oxygenation by near-infrared spectroscopy (rScO2) in 3 groups of preterm infants: 9 controls without PDA (CTRL); 9 infants with pharmalogical closure (INDOI); and 9 infants with surgical closure (SURG). Monitoring started before treatment up to 48h after treatment. Infants were matched for GA, BW and severity of illness. Infants had volumetric 3D-MRI at 40wks to calculate cerebral tissue volumes.
Results: GA and BW of three groups were 26.9±0.6, 26.8±1.1 and 26.4±1.0wks, and 928±185, 917±155 and 896±141g respectively. Lowest mean rScO2 values±SD before/during treatment were 58±6% for INDO and 53±7% for SURG vs CTRLs: 65±5% (reference values: 63-71%), p< 0.001. Brain volumes are shown in table 1. Linear regression between ventricle volume and rScO2 showed a negative correlation: r=-0.59, p< 0.01 and r=-0.74, p< 0.02 for SURG only.
Conclusion: Lowest rScO2's were found in the SURG group, whereas ventricle volumes tended to be larger. This, and the reverse relation between rScO2 and ventricle volume in the SURG group may indicate hypoxia-induced brain tissue atrophy which (partly) explain the higher incidence of adverse outcome.
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Lemmers, P., Van Kooij, B., Anbeek, P. et al. 203 Is Cerebral Oxygen Supply Compromised in Preterm Infants Undergoing Closure of Patent Ductus Arteriosus (PDA)?. Pediatr Res 68 (Suppl 1), 106 (2010). https://doi.org/10.1203/00006450-201011001-00203
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DOI: https://doi.org/10.1203/00006450-201011001-00203