The value of ultrasonography and Doppler sonography in prognosticating long-term outcomes among full-term newborns with perinatal asphyxia

Kudrevičienė, Aušrelė; Basevičius, Algidas; Lukoševičius, Saulius; Laurynaitienė, Jūratė; Marmienė, Vitalija; Nedzelskienė, Irena; Buinauskienė, Jūratė; Stonienė, Dalia; Tamelienė, Rasa

doi:10.1016/j.medici.2014.06.007

Cited by 14 publications

(15 citation statements)

References 30 publications

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“…Furthermore, vascular magnetic resonance imaging has been suggested as another option for peri-surgical assessment, 23 as well as analyzing other factors involved. 24…”

Section: Discussionmentioning

confidence: 99%

Neurological repercussions of changes in cerebral blood flow in neonates undergoing cardiovascular surgery

Feria-Kaiser¹,

Rendón-Macı́as²,

Martínez-Meraz³

et al. 2023

GMM

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Introduction: Surgery for congenital heart disease can generate cerebral perfusion-associated alterations with neurological repercussions. Objective: To analyze the relationship of peri-surgical cerebrovascular resistance index (RI) with mediate neurological functions after congenital heart disease surgery. Method: Prospective cohort study of 34 neonates in whom basilar artery RI, serum oxygen, carbon dioxide and lactate levels were determined before and after palliative or corrective procedures. We related pre-surgical RI with post-surgical ability to initiate the enteral route or to restore unassisted spontaneous breathing. Results: Three groups were formed: 79 neonates with high RI (> 0.73), 73 with normal RI (0.63 to 0.73) and eight with low RI (< 0.63). In the former group, high RI persisted in the postoperative period, with persistent hyperlactatemia and hypoxia; in 86 %, the enteral route could not be initiated, and neither could assisted ventilation be withdrawn. In the second group, RI remained within normal values. In the third group, although RI, serum lactate and arterial oxygen pressure tended to normalize, 71 % had severe neurological damage. Conclusions: RI changes were common, although neurological damage appears to occur more commonly when RI remains high, possibly associated with low cerebral blood flow.

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“…Furthermore, vascular magnetic resonance imaging has been suggested as another option for peri-surgical assessment, 23 as well as analyzing other factors involved. 24…”

Section: Discussionmentioning

confidence: 99%

Neurological repercussions of changes in cerebral blood flow in neonates undergoing cardiovascular surgery

Feria-Kaiser¹,

Rendón-Macı́as²,

Martínez-Meraz³

et al. 2023

GMM

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“…Asimismo, se ha sugerido la resonancia magnética nuclear vascular como otra opción para la valoración periquirúrgica 23 y analizar otros factores involucrados. 24…”

Section: Discussionunclassified

Repercusión neurológica por cambios en el flujo sanguíneo cerebral en neonatos sometidos a cirugía cardiovascular

Feria-Kaiser

Rendón-Macı́as

Martínez-Meraz

et al. 2020

GMM

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Introducción: La cirugía de cardiopatías congénitas puede generar alteraciones perfusorias cerebrales con repercusión neurológica. Objetivo: Analizar la relación del índice de resistencia (IR) vascular cerebral periquirúrgico con funciones neurológicas mediatas posteriores a cirugía de cardiopatía congénita. Método: Estudio de cohorte prospectivo de 34 neonatos en quienes se determinó IR de la arteria basilar, niveles séricos de oxígeno, dióxido de carbono y lactato, antes y después de procedimientos paliativos o correctivos. Relacionamos el IR prequirúrgico con la capacidad posquirúrgica para iniciar la vía enteral o restablecer la respiración espontánea no asistida. Resultados: Se integraron tres grupos: 17 neonatos con IR alto > 0.73, cinco con IR normal de 0.63 a 0.73 y seis con IR bajo < 0.63. En los primeros persistió IR alto en el posquirúrgico, con hiperlactatemia e hipoxia persistentes; en 86 % no se logró iniciar la vía enteral ni retirar la ventilación asistida. En los segundos, el IR se mantuvo en valores normales. En los terceros, si bien el IR, el lactato sérico y la presión arterial de oxígeno tendieron a normalizarse, 71 % presentó daño neurológico grave. Conclusiones: Los cambios en el IR fueron frecuentes, aunque el daño neurológico parece presentarse más cuando el IR se mantiene alto, posiblemente asociado a flujos cerebrales bajos.

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“…In addition, these procedures require a high level of expertise that is generally only available in a few advanced medical care centers, thus requiring transfer of the patient to another facility. Head ultrasonography is one portable noninvasive technology used to detect cerebral edema after brain injury (32). However, ultrasound has more limited tissue characterization capabilities than computed tomography or magnetic resonance imaging, and the magnitude of difference seen on head ultrasound following hypoxic brain injury in the first 24-48 h is often mild (33).…”

Section: Discussionmentioning

confidence: 99%

Noninvasive monitoring of brain edema after hypoxia in newborn piglets

et al. 2017

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BackgroundDevelopment of cerebral edema after brain injury carries a high risk for brain damage and death. The present study tests the ability of a noninvasive cerebral edema monitoring system that uses near-infrared spectroscopy (NIRS) with water as the chromophore of interest to detect brain edema following hypoxia.MethodsVentilated piglets were exposed to hypoxia for 1 h, and then returned to normal oxygen levels for 4 h. An NIRS sensor was placed on the animal's head at baseline, and changes in light attenuation were converted to changes in HO. Cerebral water content and aquaporin-4 protein (AQP4) expression were measured.ResultsThe system detected changes in NIRS-derived water signal as early as 2 h after hypoxia, and provided fivefold signal amplification, representing a 10% increase in brain water content and a sixfold increase in AQP4, 4 h after hypoxia. Changes in water signal correlated well with changes in cerebral water content (R=0.74) and AQP4 expression (R=0.97) in the piglet brain.ConclusionThe data show that NIRS can detect cerebral edema early in the injury process, thus providing an opportunity to initiate therapy at an earlier and more effective time-point after an insult than is available with current technology.

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The value of ultrasonography and Doppler sonography in prognosticating long-term outcomes among full-term newborns with perinatal asphyxia

Abstract: Hypoxic-ischemic brain changes detected during ultrasonography and cerebral blood flow parameters associated with long-term outcomes of mental and neuromotor development at the age of 1-year.

Cited by 14 publications

References 30 publications

Neurological repercussions of changes in cerebral blood flow in neonates undergoing cardiovascular surgery

Neurological repercussions of changes in cerebral blood flow in neonates undergoing cardiovascular surgery

Repercusión neurológica por cambios en el flujo sanguíneo cerebral en neonatos sometidos a cirugía cardiovascular

Noninvasive monitoring of brain edema after hypoxia in newborn piglets

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