Cerebral autoregulation in the first day after preterm birth: no evidence of association with systemic inflammation

Hahn, Gitte Holst; Maroun, Lisa Leth; Larsen, Nanna; Hougaard, David M.; Sørensen, L C; Lou, Hans C.; Greisen, Gorm

doi:10.1038/pr.2011.46

Cited by 24 publications

(20 citation statements)

References 45 publications

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“…The dichotomisation between one quartile and the three other quartiles was copied from previous work on biomarkers in our group [21], and chosen before any correlations were calculated.…”

Section: Statisticsmentioning

confidence: 99%

Early biomarkers of brain injury and cerebral hypo- and hyperoxia in the SafeBoosC II trial

et al. 2017

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BackgroundThe randomized clinical trial, SafeBoosC II, examined the effect of monitoring of cerebral oxygenation by near-infrared spectroscopy combined with a guideline on treatment when cerebral oxygenation was out of the target range. Data on cerebral oxygenation was collected in both the intervention and the control group. The primary outcome was the reduction in the burden of cerebral hypo- and hyperoxia between the two groups. In this study we describe the associations between the burden of cerebral hypo- and hyperoxia, regardless of allocation to intervention or control group, and the biomarkers of brain injury from birth till term equivalent age that was collected as secondary and explorative outcomes in the SafeBoosC II trial.MethodsCerebral oxygenation was continuously monitored during the first 72h of life in 166 extremely preterm infants. Cranial ultrasound was performed at day 1,4,7,14, and 35 and at term. Electroencephalogram (EEG) was recorded at 64h. Blood-samples taken at 6 and 64 hours were analysed for the brain injury biomarkers; S100beta, brain-fatty-acid-binding-protein, and neuroketal. All analyses were conducted post hoc.ResultsSignificantly more infants with a cerebral burden of hypoxia within the 4th quartile versus infants within quartile 1–3 were diagnosed with severe intracranial haemorrhage (11/39 versus 11/117, p = 0.003), had low burst rate on EEG (12/28 versus 21/103, p = 0.015), or died (14/41 versus 18/123, p = 0.006), whereas none of these events were significantly associated with cerebral hyperoxia. The blood biomarkers were not significantly associated with the burden of cerebral hypo- or hyperoxia.ConclusionsThe explorative analysis showed that early burden of cerebral hypoxia, but not hyperoxia was significantly associated with low brain electrical activity and severe intracranial haemorrhage while none of the three blood biomarkers were associated with the burden of either cerebral hypo- or hyperoxia.

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“…The dichotomisation between one quartile and the three other quartiles was copied from previous work on biomarkers in our group [21], and chosen before any correlations were calculated.…”

Section: Statisticsmentioning

confidence: 99%

Early biomarkers of brain injury and cerebral hypo- and hyperoxia in the SafeBoosC II trial

et al. 2017

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“…19 Phase shift has not been reported for studies of CA in neonates based on spontaneous fluctuations in MAP. 8,10,[20][21][22][23] This might be due to the fact that the interpretation of phase over a frequency range is difficult. What does the average phase shift in a frequency band actually mean?…”

Section: Can We Handle the Phase Shift Between The Two Signals?mentioning

confidence: 99%

“…8 In the previous study, CA was analyzed in the frequency domain. In the present study, data were reanalyzed in the time domain for comparison.…”

Section: Calculation Of Cerebral Autoregulationmentioning

confidence: 99%

Cerebral autoregulation in the preterm newborn using near-infrared spectroscopy: a comparison of time-domain and frequency-domain analyses

2015

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Abstract. The aim was to compare two conventional methods used to describe cerebral autoregulation (CA): frequency-domain analysis and time-domain analysis. We measured cerebral oxygenation (as a surrogate for cerebral blood flow) and mean arterial blood pressure (MAP) in 60 preterm infants. In the frequency domain, outcome variables were coherence and gain, whereas the cerebral oximetry index (COx) and the regression coefficient were the outcome variables in the time domain. Correlation between coherence and COx was poor.The disagreement between the two methods was due to the MAP and cerebral oxygenation signals being in counterphase in three cases. High gain and high coherence may arise spuriously when cerebral oxygenation decreases as MAP increases; hence, time-domain analysis appears to be a more robust-and simpler-method to describe CA.

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“…22,23 It has been suggested that reduced cerebral oxygenation may contribute to impaired arousal, 22 which is seen in the prone position in both term 18,24 and preterm infants [25][26][27] and is likely to be significant in the pathophysiology of SIDS. 10,28 Preterm infants display immature cerebrovascular control before termequivalent age, [29][30][31][32] the severity of which is related to their GA at birth. 30 However, little is known about cerebral oxygenation in preterm infants during the period of greatest SIDS risk.…”

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confidence: 99%

Cerebral Oxygenation in Preterm Infants

et al. 2014

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BACKGROUND AND OBJECTIVE: Prone sleeping is a major risk factor for sudden infant death syndrome (SIDS) and preterm infants are at significantly increased risk. In term infants, prone sleeping is associated with reduced mean arterial pressure (MAP) and cerebral tissue oxygenation index (TOI). However, little is known about the effects of sleeping position on TOI and MAP in preterm infants. We aimed to examine TOI and MAP in preterm infants after term-equivalent age, during the period of greatest SIDS risk. METHODS: Thirty-five preterm and 17 term infants underwent daytime polysomnography, including measurement of TOI (NIRO-200 spectrophotometer, Hamamatsu Photonics KK, Japan) and MAP (Finapress Medical Systems, Amsterdam, Netherlands) at 2 to 4 weeks, 2 to 3 months, and 5 to 6 months postterm age. Infants slept prone and supine in active and quiet sleep. The effects of sleep state and position were determined by using 2-way repeated measures analysis of variance and of preterm birth by using 2-way analysis of variance. RESULTS: In preterm infants, TOI was significantly lower when prone compared with supine in both sleep states at all ages (P < .05). Notably, TOI was significantly lower in preterm compared with term infants at 2 to 4 weeks, in both positions (P < .05), and at 2 to 3 months when prone (P < .001), in both sleep states. MAP was also lower in preterm infants in the prone position at 2 to 3 months (P < .01). CONCLUSIONS: Cerebral oxygenation is reduced in the prone position in preterm infants and is lower compared with age-matched term infants, predominantly in the prone position when MAP is also reduced. This may contribute to their increased SIDS risk.

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Cerebral autoregulation in the first day after preterm birth: no evidence of association with systemic inflammation

Cited by 24 publications

References 45 publications

Early biomarkers of brain injury and cerebral hypo- and hyperoxia in the SafeBoosC II trial

Early biomarkers of brain injury and cerebral hypo- and hyperoxia in the SafeBoosC II trial

Cerebral autoregulation in the preterm newborn using near-infrared spectroscopy: a comparison of time-domain and frequency-domain analyses

Cerebral Oxygenation in Preterm Infants

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