Avaliação precoce do comportamento oculomotor em bebês com displasia broncopulmonar

Abstract

This study evaluated the oculomotor system measured by eye movements in infants diagnosed with bronchopulmonary dysplasia (BPD). Infants ≤ 37 weeks gestational age, oxygen-dependent at concentrations above 21% for more than 28 days were included in the BPD group, term infants (gestational age > 37 weeks), not hospitalized were included in term groups and preterm infants (gestational age < 37 weeks), who remained hospitalized and did not use oxygen for more than 10 days were included in the premature group. The three groups of babies had eye examination and biomicroscopy of the fundus with normal results. Excluded from the study, babies on oxygen in mechanical ventilation and/ or vasoactive drugs; with a diagnosis of intracranial hemorrhage, retinopathy of prematurity, motor and/or neurological congenital or acquired malformations identified in neonatal or during the stay in the nursery. All infants made a single binocular assessment. The evaluations were conducted with babies seated comfortably and were composed by the evaluation of four eye movements: saccades (SAC), slow pursuit (PL), vestibuloocular reflex (VOR) and optokinetic nystagmus (NOC). Eye movements were transcribed into a categorical variable (present or absent) and statistical analysis were made between BPD group, term group and premature group (Cochran Q test) to ensure reliable of the results presented during the evaluation, 28 % of the sample was evaluated by three observers and an adherence X 2 test was used to measure the reliable between three observers. During the study, 109 infants were evaluated, 107 were included in the study, two infants with GA < 37 weeks, were excluded by using oxygen for a time equal to 15 days. Of the 107 infants evaluated, 23 were included in the BPD group, 47 in the term group and 37 in the premature group. Babies in the BPD group had GA of 32 weeks ± 3 weeks, APGAR 1 st minute 6 ± 1, 5 th minutes 8 ± 2, 37 days ± 10 days in oxygen, in the median amount of 2 L / min ± 0.5 L / min. Birth weight, gestational age, APGAR score at 1 st and 5 th minutes from the term group, DBP and Premature differ significantly (Kruskal-Wallis test p = 0.0000, 0.0000, 0.0013 and 0.0001, respectively). The term group had higher values when compared to the BPD and premature. Babies with BPD manifest absence of three of the four types of eye movements measured when compared with the term group and preterm (Cochran Q test where Q > 2 and p < 0.05).

Perspectivas Atuais e Futuras nas Abordagens Terapêuticas para Hipertensão Pulmonar Persistente Neonatal.

“…6 Ferreira et al 2018 Explorou o uso do sildenafil no tratamento da hipertensão pulmonar em prematuros com displasia broncopulmonar, investigando sua eficácia em um grupo específico de recém-nascidos.…”

“…Este artigo propõe uma revisão integrativa das diferentes abordagens terapêuticas existentes para o tratamento da HPPRN em recém-nascidos, com um foco especial no papel do sildenafil Miranda et al (2014), Ferreira et al (2018) e Yassem et al (2012. As referências selecionadas abordam aspectos fundamentais, desde a etiopatogenia até a percepção clínica dos profissionais de saúde, oferecendo uma perspectiva abrangente sobre a evolução das estratégias terapêuticas nesta área Magalhães et al (2011), Rodrigues et al (2008, Rodrigues et al (2021), Colvero et al (2006), Neves et al (2011) e Carvalho et al (2005.…”