Resistive indices of cerebral arteries in very preterm infants: values throughout stay in the neonatal intensive care unit and impact of patent ductus arteriosus

Ecury-Goossen, Ginette M.; Raets, Marlou M. A.; Camfferman, Fleur; Vos, Rik; Rosmalen, Joost van; Reiss, Irwin; Govaert, Paul; Dudink, Jeroen

doi:10.1007/s00247-016-3615-x

Cited by 31 publications

(35 citation statements)

References 28 publications

(31 reference statements)

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…This is in line with previous studies demonstrating a good correlation between flow indices in the anterior and in the middle cerebral artery, 15,33 as well as between the right and left great vessels. 34 These findings support that identifying exactly the same vessel is not essential to assess the cerebral circulation. NeoDoppler can therefore be feasible for non-expert users, who can focus only on capturing a high-quality flow signal within the broad ultrasound beam.…”

Section: New Features Obtained With Neodopplermentioning

confidence: 64%

NeoDoppler: New ultrasound technology for continuous cerebral circulation monitoring in neonates

et al. 2019

View full text Add to dashboard Cite

BACKGROUND: There is a strong need for continuous cerebral circulation monitoring in neonatal care, since suboptimal cerebral blood flow may lead to brain injuries in preterm infants and other critically ill neonates. NeoDoppler is a novel ultrasound system, which can be gently fixed to the anterior fontanel and measure cerebral blood flow velocity continuously in different depths of the brain simultaneously. We aimed to study the feasibility, accuracy, and potential clinical applications of NeoDoppler in preterm infants and sick neonates. METHOD: Twenty-five infants born at different gestational ages with a variety of diagnoses on admission were included. The probe was placed over the anterior fontanel, and blood flow velocity data were continuously recorded. To validate NeoDoppler, we compared the measurements with conventional ultrasound; agreement was assessed using Bland-Altman plots. RESULTS: NeoDoppler can provide accurate and continuous data on cerebral blood flow velocity in several depths simultaneously. Limits of agreement between the measurements obtained with the two methods were acceptable. CONCLUSION: By monitoring the cerebral circulation continuously, increased knowledge of cerebral hemodynamics in preterm infants and sick neonates may be acquired. Improved monitoring of these vulnerable brains during a very sensitive period of brain development may contribute toward preventing brain injuries.

show abstract

Section: New Features Obtained With Neodopplermentioning

confidence: 64%

NeoDoppler: New ultrasound technology for continuous cerebral circulation monitoring in neonates

et al. 2019

View full text Add to dashboard Cite

show abstract

“…The internal carotid artery (ICA) was examined in two studies. 40,47 Both concluded that there was a significantly higher RI in the ICA in the presence of a hemodynamically significant PDA (median RI 0.82 in PDA versus 0.75 in controls-p < 0.001 47 and mean RI 0.97 in PDA versus 0.81 in controls-p < 0.05 40 ). The RI in the common carotid artery (CCA) and in the basilar artery and striatal and pial arteries did not show significant differences in preterm infants with and without hemodynamically significant PDA.…”

Section: Results Of Individual Studiesmentioning

confidence: 98%

“…Mean RI varied between 0.78 and 1.2 in a large PDA compared to RI of 0.61-0.81 in preterm infants without a significant PDA. 25,26,28,29,31,40,44,47 Five of these studies used the duplex method without 2D ultrasound. RI in the middle cerebral artery (MCA) was investigated in two studies, 39,40 showing a significantly higher RI in patients with PDA.…”

Section: Results Of Individual Studiesmentioning

confidence: 99%

“…The RI in the common carotid artery (CCA) and in the basilar artery and striatal and pial arteries did not show significant differences in preterm infants with and without hemodynamically significant PDA. 28,47 Other parameters studied in relation to PDA were coefficient of variation, 38 PI, 39 MV, 28,34,39,40 peak-systolic velocity, end-systolic and end-diastolic velocities, 29 or maximum and minimum velocities (ratio min-max MV). 34 For MV, three out of four studies showed significantly lower values in infants with hemodynamically significant PDA.…”

Section: Results Of Individual Studiesmentioning

confidence: 99%

“…For instance, Bravo et al 54 showed that an RI of ≥0.74 measured 24 h after termination of ibuprofen treatment was the best biomarker of moderate-to-large PDA (sensitivity 82% (52-95%), specificity 72% (54-84%), positive predictive value 50% (29-71%), and negative predictive value 92% (75-98%). Interestingly, surgical closure of a PDA did not change RI values 47 and did not improve the long-term neurodevelopmental outcome. 55 However, in these studies a hemodynamically significant PDA usually is defined only by PDA size, flow pattern, and signs of pulmonary overflow expressed as left atriumto-aorta ratio (LA:Ao).…”

Section: Persistent Ductus Arteriosusmentioning

confidence: 87%

See 2 more Smart Citations

Diagnostic and predictive value of Doppler ultrasound for evaluation of the brain circulation in preterm infants: a systematic review

et al. 2020

Self Cite

View full text Add to dashboard Cite

Cools 1 on behalf of the eurUS.brain group INTRODUCTION: Very and extremely preterm infants frequently have brain injury-related long-term neurodevelopmental problems. Altered perfusion, for example, seen in the context of a hemodynamically significant patent ductus arteriosus (PDA), has been linked to injury of the immature brain. However, a direct relation with outcome has not been reviewed systematically. METHODS: A systematic review was conducted to provide an overview of the value of different cerebral arterial blood flow parameters assessed by Doppler ultrasound, in relation to brain injury, to predict long-term neurodevelopmental outcome in preterm infants. RESULTS: In total, 23 studies were included. Because of heterogeneity of studies, a meta-analysis of results was not possible. All included studies on resistance index (RI) showed significantly higher values in subjects with a hemodynamically significant PDA. However, absolute differences in RI values were small. Studies using Doppler parameters to predict brain injury and long-term neurodevelopmental outcome were inconsistent. DISCUSSION: There is no clear evidence to support the routine determination of RI or other Doppler parameters in the cerebral arteries to predict brain injury and long-term neurodevelopmental outcome in the preterm infant. However, there is evidence that elevated RI can point to the presence of a hemodynamically significant PDA.

show abstract

Hemodynamic effects of high‐frequency oscillatory ventilation in preterm neonates with respiratory distress syndrome

Ayoub

Elmashad

Rowisha

et al. 2020

Pediatric Pulmonology

View full text Add to dashboard Cite

Background: High-frequency oscillatory ventilation (HFOV) can have negative hemodynamic effects in neonates. We aimed to assess systemic, cerebral, and cardiac hemodynamic changes in preterm neonates with respiratory distress syndrome (RDS) on HFOV. Methods: This observational study was conducted from June 2017 until May 2019 on 100 preterm neonates with RDS that needed switching from conventional mechanical ventilation to HFOV. Initial and Follow up capillary blood gas, echocardiographic examination, cranial ultrasound, and Doppler study of cerebral, celiac, superior mesenteric, and renal arteries using resistive index (RI) were performed before, 24 h, and 72 h after the use of HFOV. Results: There was no statistically significant difference as regards cardiac function, heart rate, or intraventricular hemorrhage on follow up measurements. However blood pressure, left ventricular dimensions, and volumes statistically increased after HFOV. There was a statistically significant decrease in the pulmonary artery systolic pressure after the use of HFOV. After the use of HFOV, there was a statistically significant increase in the superior vena cava flow and left ventricular output while right ventricular output values initially increased then slightly decreased but still higher than the initial values. RI of cerebral, superior mesenteric, celiac, and renal arteries significantly decreased on follow up measurements which reflected increased blood flow in these arteries. Conclusion: HFOV had no negative effect on the cerebral, systemic, or cardiac hemodynamics when applied at optimum MAP. Therefore, concerns about negative hemodynamic effects of HFOV should not discourage the use of HFOV when deemed clinically indicated provided the use of optimum MAP.

show abstract

Resistive indices of cerebral arteries in very preterm infants: values throughout stay in the neonatal intensive care unit and impact of patent ductus arteriosus

Cited by 31 publications

References 28 publications

NeoDoppler: New ultrasound technology for continuous cerebral circulation monitoring in neonates

NeoDoppler: New ultrasound technology for continuous cerebral circulation monitoring in neonates

Diagnostic and predictive value of Doppler ultrasound for evaluation of the brain circulation in preterm infants: a systematic review

Hemodynamic effects of high‐frequency oscillatory ventilation in preterm neonates with respiratory distress syndrome

Contact Info

Product

Resources

About