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Feasibility of Doppler Ultrasound for Cortical Cerebral Blood Flow Velocity Monitoring During Major Non-cardiac Surgery of Newborns

Background and Aim: Newborns needing major surgical intervention are at risk of brain injury and impaired neurodevelopment later in life. Disturbance of cerebral perfusion might be an underlying factor. This study investigates the feasibility of serial transfontanellar ultrasound measurements of the...

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Autores principales: Costerus, Sophie A., Kortenbout, Anna J., Vos, Hendrik J., Govaert, Paul, Tibboel, Dick, Wijnen, René M. H., de Jong, Nico, Bosch, Johan G., de Graaff, Jurgen C.
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Frontiers Media S.A. 2021
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8019737/
https://www.ncbi.nlm.nih.gov/pubmed/33829005
http://dx.doi.org/10.3389/fped.2021.656806
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author Costerus, Sophie A.
Kortenbout, Anna J.
Vos, Hendrik J.
Govaert, Paul
Tibboel, Dick
Wijnen, René M. H.
de Jong, Nico
Bosch, Johan G.
de Graaff, Jurgen C.
author_facet Costerus, Sophie A.
Kortenbout, Anna J.
Vos, Hendrik J.
Govaert, Paul
Tibboel, Dick
Wijnen, René M. H.
de Jong, Nico
Bosch, Johan G.
de Graaff, Jurgen C.
author_sort Costerus, Sophie A.
collection PubMed
description Background and Aim: Newborns needing major surgical intervention are at risk of brain injury and impaired neurodevelopment later in life. Disturbance of cerebral perfusion might be an underlying factor. This study investigates the feasibility of serial transfontanellar ultrasound measurements of the pial arteries during neonatal surgery, and whether perioperative changes in cerebral perfusion can be observed and related to changes in the perioperative management. Methods: In this prospective, observational feasibility study, neonates with congenital diaphragmatic hernia and esophageal atresia scheduled for surgical treatment within the first 28 days of life were eligible for inclusion. We performed transfontanellar directional power Doppler and pulsed wave Doppler ultrasound during major high-risk non-cardiac neonatal surgery. Pial arteries were of interest for the measurements. Extracted Doppler ultrasound parameters were: peak systolic velocity, end diastolic velocity, the resistivity index and pulsatility index. Results: In 10 out of 14 patients it was possible to perform perioperative measurements; the others failed for logistic and technical reasons. In 6 out of 10 patients, it was feasible to perform serial intraoperative transfontanellar ultrasound measurements with directional power Doppler and pulsed wave Doppler of the same pial artery during neonatal surgery. Median peak systolic velocity was ranging between 5.7 and 7.0 cm s(−1) and end diastolic velocity between 1.9 and 3.2 cm s(−1). In patients with a vasoactive-inotropic score below 12 the trend of peak systolic velocity and end diastolic velocity corresponded with the mean arterial blood pressure trend. Conclusion: Perioperative transfontanellar ultrasound Doppler measurements of the pial arteries are feasible and provide new longitudinal data about perioperative cortical cerebral blood flow velocity. Trial Registration: https://www.trialregister.nl/trial/6972, identifier: NL6972.
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spelling pubmed-80197372021-04-06 Feasibility of Doppler Ultrasound for Cortical Cerebral Blood Flow Velocity Monitoring During Major Non-cardiac Surgery of Newborns Costerus, Sophie A. Kortenbout, Anna J. Vos, Hendrik J. Govaert, Paul Tibboel, Dick Wijnen, René M. H. de Jong, Nico Bosch, Johan G. de Graaff, Jurgen C. Front Pediatr Pediatrics Background and Aim: Newborns needing major surgical intervention are at risk of brain injury and impaired neurodevelopment later in life. Disturbance of cerebral perfusion might be an underlying factor. This study investigates the feasibility of serial transfontanellar ultrasound measurements of the pial arteries during neonatal surgery, and whether perioperative changes in cerebral perfusion can be observed and related to changes in the perioperative management. Methods: In this prospective, observational feasibility study, neonates with congenital diaphragmatic hernia and esophageal atresia scheduled for surgical treatment within the first 28 days of life were eligible for inclusion. We performed transfontanellar directional power Doppler and pulsed wave Doppler ultrasound during major high-risk non-cardiac neonatal surgery. Pial arteries were of interest for the measurements. Extracted Doppler ultrasound parameters were: peak systolic velocity, end diastolic velocity, the resistivity index and pulsatility index. Results: In 10 out of 14 patients it was possible to perform perioperative measurements; the others failed for logistic and technical reasons. In 6 out of 10 patients, it was feasible to perform serial intraoperative transfontanellar ultrasound measurements with directional power Doppler and pulsed wave Doppler of the same pial artery during neonatal surgery. Median peak systolic velocity was ranging between 5.7 and 7.0 cm s(−1) and end diastolic velocity between 1.9 and 3.2 cm s(−1). In patients with a vasoactive-inotropic score below 12 the trend of peak systolic velocity and end diastolic velocity corresponded with the mean arterial blood pressure trend. Conclusion: Perioperative transfontanellar ultrasound Doppler measurements of the pial arteries are feasible and provide new longitudinal data about perioperative cortical cerebral blood flow velocity. Trial Registration: https://www.trialregister.nl/trial/6972, identifier: NL6972. Frontiers Media S.A. 2021-03-22 /pmc/articles/PMC8019737/ /pubmed/33829005 http://dx.doi.org/10.3389/fped.2021.656806 Text en Copyright © 2021 Costerus, Kortenbout, Vos, Govaert, Tibboel, Wijnen, de Jong, Bosch and de Graaff. http://creativecommons.org/licenses/by/4.0/ This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner(s) are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
spellingShingle Pediatrics
Costerus, Sophie A.
Kortenbout, Anna J.
Vos, Hendrik J.
Govaert, Paul
Tibboel, Dick
Wijnen, René M. H.
de Jong, Nico
Bosch, Johan G.
de Graaff, Jurgen C.
Feasibility of Doppler Ultrasound for Cortical Cerebral Blood Flow Velocity Monitoring During Major Non-cardiac Surgery of Newborns
title Feasibility of Doppler Ultrasound for Cortical Cerebral Blood Flow Velocity Monitoring During Major Non-cardiac Surgery of Newborns
title_full Feasibility of Doppler Ultrasound for Cortical Cerebral Blood Flow Velocity Monitoring During Major Non-cardiac Surgery of Newborns
title_fullStr Feasibility of Doppler Ultrasound for Cortical Cerebral Blood Flow Velocity Monitoring During Major Non-cardiac Surgery of Newborns
title_full_unstemmed Feasibility of Doppler Ultrasound for Cortical Cerebral Blood Flow Velocity Monitoring During Major Non-cardiac Surgery of Newborns
title_short Feasibility of Doppler Ultrasound for Cortical Cerebral Blood Flow Velocity Monitoring During Major Non-cardiac Surgery of Newborns
title_sort feasibility of doppler ultrasound for cortical cerebral blood flow velocity monitoring during major non-cardiac surgery of newborns
topic Pediatrics
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8019737/
https://www.ncbi.nlm.nih.gov/pubmed/33829005
http://dx.doi.org/10.3389/fped.2021.656806
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