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Posthemorrhagic ventricular dilatation late intervention threshold and associated brain injury

OBJECTIVE: To systematically assess white matter injury (WMI) in preterm infants with posthemorrhagic ventricular dilatation (PHVD) using a high-threshold intervention strategy. STUDY DESIGN: This retrospective analysis included 85 preterm infants (≤34 weeks of gestation) with grade 2–3 germinal mat...

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Autores principales: Valverde, Eva, Ybarra, Marta, Benito, Andrea V., Bravo, María Carmen, Pellicer, Adelina
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Public Library of Science 2022
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9612444/
https://www.ncbi.nlm.nih.gov/pubmed/36301835
http://dx.doi.org/10.1371/journal.pone.0276446
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author Valverde, Eva
Ybarra, Marta
Benito, Andrea V.
Bravo, María Carmen
Pellicer, Adelina
author_facet Valverde, Eva
Ybarra, Marta
Benito, Andrea V.
Bravo, María Carmen
Pellicer, Adelina
author_sort Valverde, Eva
collection PubMed
description OBJECTIVE: To systematically assess white matter injury (WMI) in preterm infants with posthemorrhagic ventricular dilatation (PHVD) using a high-threshold intervention strategy. STUDY DESIGN: This retrospective analysis included 85 preterm infants (≤34 weeks of gestation) with grade 2–3 germinal matrix-intraventricular hemorrhage. Cranial ultrasound (cUS) scans were assessed for WMI and ventricular width and shape. Forty-eight infants developed PHVD, 21 of whom (intervention group) underwent cerebrospinal fluid drainage according to a predefined threshold (ventricular index ≥p97+4 mm or anterior horn width >10 mm, and the presence of frontal horn ballooning). The other 27 infants underwent a conservative approach (non-intervention group). The two PHVD groups were compared regarding ventricular width at two stages: the worst cUS for the non-intervention group (scans showing the largest ventricular measurements) versus pre-intervention cUS in the intervention group, and at term equivalent age. WMI was classified as normal/mild, moderate and severe. RESULTS: The intervention group showed significantly larger ventricular index, anterior horn width and thalamo-occipital diameter than the non-intervention group at the two timepoints. Moderate and severe WMI were more frequent in the infants with PHVD (p<0.001), regardless of management (intervention or conservative management). There was a linear relationship between the severity of PHVD and WMI (p<0.001). CONCLUSIONS: Preterm infants with PHVD who undergo a high-threshold intervention strategy associate an increased risk of WMI.
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spelling pubmed-96124442022-10-28 Posthemorrhagic ventricular dilatation late intervention threshold and associated brain injury Valverde, Eva Ybarra, Marta Benito, Andrea V. Bravo, María Carmen Pellicer, Adelina PLoS One Research Article OBJECTIVE: To systematically assess white matter injury (WMI) in preterm infants with posthemorrhagic ventricular dilatation (PHVD) using a high-threshold intervention strategy. STUDY DESIGN: This retrospective analysis included 85 preterm infants (≤34 weeks of gestation) with grade 2–3 germinal matrix-intraventricular hemorrhage. Cranial ultrasound (cUS) scans were assessed for WMI and ventricular width and shape. Forty-eight infants developed PHVD, 21 of whom (intervention group) underwent cerebrospinal fluid drainage according to a predefined threshold (ventricular index ≥p97+4 mm or anterior horn width >10 mm, and the presence of frontal horn ballooning). The other 27 infants underwent a conservative approach (non-intervention group). The two PHVD groups were compared regarding ventricular width at two stages: the worst cUS for the non-intervention group (scans showing the largest ventricular measurements) versus pre-intervention cUS in the intervention group, and at term equivalent age. WMI was classified as normal/mild, moderate and severe. RESULTS: The intervention group showed significantly larger ventricular index, anterior horn width and thalamo-occipital diameter than the non-intervention group at the two timepoints. Moderate and severe WMI were more frequent in the infants with PHVD (p<0.001), regardless of management (intervention or conservative management). There was a linear relationship between the severity of PHVD and WMI (p<0.001). CONCLUSIONS: Preterm infants with PHVD who undergo a high-threshold intervention strategy associate an increased risk of WMI. Public Library of Science 2022-10-27 /pmc/articles/PMC9612444/ /pubmed/36301835 http://dx.doi.org/10.1371/journal.pone.0276446 Text en © 2022 Valverde et al https://creativecommons.org/licenses/by/4.0/This is an open access article distributed under the terms of the Creative Commons Attribution License (https://creativecommons.org/licenses/by/4.0/) , which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.
spellingShingle Research Article
Valverde, Eva
Ybarra, Marta
Benito, Andrea V.
Bravo, María Carmen
Pellicer, Adelina
Posthemorrhagic ventricular dilatation late intervention threshold and associated brain injury
title Posthemorrhagic ventricular dilatation late intervention threshold and associated brain injury
title_full Posthemorrhagic ventricular dilatation late intervention threshold and associated brain injury
title_fullStr Posthemorrhagic ventricular dilatation late intervention threshold and associated brain injury
title_full_unstemmed Posthemorrhagic ventricular dilatation late intervention threshold and associated brain injury
title_short Posthemorrhagic ventricular dilatation late intervention threshold and associated brain injury
title_sort posthemorrhagic ventricular dilatation late intervention threshold and associated brain injury
topic Research Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9612444/
https://www.ncbi.nlm.nih.gov/pubmed/36301835
http://dx.doi.org/10.1371/journal.pone.0276446
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