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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