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Early Cerebrovascular Autoregulation in Neonates with Congenital Heart Disease

Neonates with congenital heart disease (CHD) display delayed brain development, predisposing them to impaired cerebrovascular autoregulation (CAR) and ischemic brain injury. For this paper, we analyzed the percentage of time with impaired CAR (%time impaired CAR) during the first 72 h after birth, t...

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Autores principales: Brunsch, Celina L., Mebius, Mirthe J., Berger, Rolf M. F., Bos, Arend F., Kooi, Elisabeth M. W.
Formato: Online Artículo Texto
Lenguaje:English
Publicado: MDPI 2022
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9688918/
https://www.ncbi.nlm.nih.gov/pubmed/36360414
http://dx.doi.org/10.3390/children9111686
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author Brunsch, Celina L.
Mebius, Mirthe J.
Berger, Rolf M. F.
Bos, Arend F.
Kooi, Elisabeth M. W.
author_facet Brunsch, Celina L.
Mebius, Mirthe J.
Berger, Rolf M. F.
Bos, Arend F.
Kooi, Elisabeth M. W.
author_sort Brunsch, Celina L.
collection PubMed
description Neonates with congenital heart disease (CHD) display delayed brain development, predisposing them to impaired cerebrovascular autoregulation (CAR) and ischemic brain injury. For this paper, we analyzed the percentage of time with impaired CAR (%time impaired CAR) during the first 72 h after birth, the relation with clinical factors, and survival in 57 neonates with CHD. The primary outcome was a correlation coefficient of cerebral oxygenation (r(c)SO(2)) and mean arterial blood pressure (MABP, mmHg) for two hours on a daily basis. The %time impaired CAR ranged from 9.3% of the studied time on day one to 4.6% on day three. Variables associated with more %time impaired CAR were the use of inotropes (day 1, B = 19.5, 95%CI = 10.6–28.3; day 3, B = 11.5, 95%CI = 7.1–16), lower MABP (day 1, B = −0.6, 95%CI = −1.2–0.0), and dextro-transposition of the great arteries (dTGA) (16.2%) compared with other CHD types (2.0–5.0%; day 1, p = 0.022). Survival was not an associated variable. To summarize, impaired CAR was found in CHD neonates in up to 9.3% of the studied time. More evidence is necessary to evaluate an association with inotropes, dTGA, %time impaired CAR, and long-term outcome, further in larger cohorts.
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spelling pubmed-96889182022-11-25 Early Cerebrovascular Autoregulation in Neonates with Congenital Heart Disease Brunsch, Celina L. Mebius, Mirthe J. Berger, Rolf M. F. Bos, Arend F. Kooi, Elisabeth M. W. Children (Basel) Article Neonates with congenital heart disease (CHD) display delayed brain development, predisposing them to impaired cerebrovascular autoregulation (CAR) and ischemic brain injury. For this paper, we analyzed the percentage of time with impaired CAR (%time impaired CAR) during the first 72 h after birth, the relation with clinical factors, and survival in 57 neonates with CHD. The primary outcome was a correlation coefficient of cerebral oxygenation (r(c)SO(2)) and mean arterial blood pressure (MABP, mmHg) for two hours on a daily basis. The %time impaired CAR ranged from 9.3% of the studied time on day one to 4.6% on day three. Variables associated with more %time impaired CAR were the use of inotropes (day 1, B = 19.5, 95%CI = 10.6–28.3; day 3, B = 11.5, 95%CI = 7.1–16), lower MABP (day 1, B = −0.6, 95%CI = −1.2–0.0), and dextro-transposition of the great arteries (dTGA) (16.2%) compared with other CHD types (2.0–5.0%; day 1, p = 0.022). Survival was not an associated variable. To summarize, impaired CAR was found in CHD neonates in up to 9.3% of the studied time. More evidence is necessary to evaluate an association with inotropes, dTGA, %time impaired CAR, and long-term outcome, further in larger cohorts. MDPI 2022-11-03 /pmc/articles/PMC9688918/ /pubmed/36360414 http://dx.doi.org/10.3390/children9111686 Text en © 2022 by the authors. https://creativecommons.org/licenses/by/4.0/Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/).
spellingShingle Article
Brunsch, Celina L.
Mebius, Mirthe J.
Berger, Rolf M. F.
Bos, Arend F.
Kooi, Elisabeth M. W.
Early Cerebrovascular Autoregulation in Neonates with Congenital Heart Disease
title Early Cerebrovascular Autoregulation in Neonates with Congenital Heart Disease
title_full Early Cerebrovascular Autoregulation in Neonates with Congenital Heart Disease
title_fullStr Early Cerebrovascular Autoregulation in Neonates with Congenital Heart Disease
title_full_unstemmed Early Cerebrovascular Autoregulation in Neonates with Congenital Heart Disease
title_short Early Cerebrovascular Autoregulation in Neonates with Congenital Heart Disease
title_sort early cerebrovascular autoregulation in neonates with congenital heart disease
topic Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9688918/
https://www.ncbi.nlm.nih.gov/pubmed/36360414
http://dx.doi.org/10.3390/children9111686
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