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Cerebral blood volume changes during closure by surgery of patent ductus arteriosus
  1. Britta M Huening (britta.huening{at}gmx.de)
  1. Klinik für Kinder- und Jugendmedizin der Universität Duisburg-Essen, Germany
    1. Boulos Asfour
    1. Deutsches Kinderherzzentrum St. Augustin, Germany
      1. Sascha Koenig
      1. Klinik für Kinder- und Jugendmedizin der Universität Duisburg-Essen, Germany
        1. Nadine Heß
        1. Klinik für Kinder- und Jugendmedizin der Universität Duisburg-Essen, Germany
          1. Claudia Roll (claudia.roll{at}uni-essen.de)
          1. Vestische Kinder- und Jugendklinik Datteln, Universität Witten-Herdecke, Germany

            Abstract

            Objective: Surgical closure of a patent ductus arteriosus (PDA) in very low birth weight (VLBW) infants has been associated with impaired neurodevelopmental outcome. Surgical PDA closure may result in abrupt changes of cerebral haemodynamics.

            Design: Continuous cerebral near-infrared spectroscopy (NIRS) recording throughout PDA surgery. Setting: Tertiary neonatal intensive care unit, with PDA surgery performed on the ward.

            Patients: Ten VLBW infants, birth weight 748 (590-1070) g (median, range), gestational age 24 (23-27) wks, chronological age 14 (12-22) d.

            Intervention: Surgical closure of PDA.

            Main outcome measures: Changes in cerebral oxygenated haemoglobin, cerebral deoxygenated haemoglobin, and tissue oxygenation index (measured), changes in cerebral blood volume (CBV) and cerebral haemoglobin difference (calculated) as measured by near-infrared spectroscopy.

            Results: During the first 2 minutes after closure of the PDA, CBV increased significantly (+0.14 ml/100 g tissue; SD 0.12; p=0.01) and returned to baseline within 2 to 5 minutes. Cerebral oxygenation did not change. Conclusions: There is a short lasting increase in CBV immediately following surgical closure of PDA, but no change in cerebral oxygenation. These transient changes are unlikely to cause harm.

            • cerebral haemodynamics and oxygenation
            • near-infrared spectroscopy
            • very low birth weight infant

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