Assessing cerebrovascular autoregulation in infants with necrotizing enterocolitis using near-infrared spectroscopy

Schat, Trijntje E.; Laan, Michelle E. van der; Schurink, Maarten; Hulscher, Jan B F; Hulzebos, Christian V.; Bos, Arend F.; Kooi, Elisabeth M. W.

doi:10.1038/pr.2015.184

Cited by 18 publications

(15 citation statements)

References 33 publications

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“…Although one might assume that in NEC infants intestinal perfusion would be lower in infants predisposed to NEC, in fact cerebral oxygenation rather than intestinal oxygenation is impaired in the first days of life in infants who go on to develop NEC, whereas intestinal perfusion is impaired immediately preceding clinical NEC [30]. In a further study, although NIRS could not distinguish between definite NEC and the absence of NEC, it could differentiate between complicated and uncomplicated NEC [31].…”

Section: Improved Diagnostic Methodsmentioning

confidence: 99%

Current Research on the Epidemiology, Pathogenesis, and Management of Necrotizing Enterocolitis

2017

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Despite decades of research on necrotizing enterocolitis, we still do not fully understand the pathogenesis of the disease, or how to prevent or how to treat it. However, as a result of recent significant advances in the microbiology, molecular biology, and cell biology of the intestine of preterm infants and infants with necrotizing enterocolitis, there is some hope that research into this devastating disease will yield some important translation into effective prevention, more rapid diagnosis, and novel therapies.

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Section: Improved Diagnostic Methodsmentioning

confidence: 99%

Current Research on the Epidemiology, Pathogenesis, and Management of Necrotizing Enterocolitis

2017

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“…Of 10 674 abstracts screened, 203 full-text articles were thoroughly examined, and 53 studies were included in the final analysis (figure 1). Of the latter, 21 were designed to address neurodevelopmental outcome and/or neuroimaging abnormalities in NEC survivors,11 12 19–37 and 11 of these were prospective studies 11 20 22 23 26–29 32 35 37…”

Section: Resultsmentioning

confidence: 99%

Neurodevelopmental impairment in necrotising enterocolitis survivors: systematic review and meta-analysis

Matei

Montalva

Goodbaum

et al. 2019

Arch Dis Child Fetal Neonatal Ed

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AimTo determine (1) the incidence of neurodevelopmental impairment (NDI) in necrotising enterocolitis (NEC), (2) the impact of NEC severity on NDI in these babies and (3) the cerebral lesions found in babies with NEC.MethodsSystematic review: three independent investigators searched for studies reporting infants with NDI and a history of NEC (PubMed, Medline, Cochrane Collaboration, Scopus). Meta-analysis: using RevMan V.5.3, we compared NDI incidence and type of cerebral lesions between NEC infants versus preterm infants and infants with medical vs surgical NEC.ResultsOf 10 674 abstracts screened, 203 full-text articles were examined. In 31 studies (n=2403 infants with NEC), NDI incidence was 40% (IQR 28%–64%) and was higher in infants with surgically treated NEC (43%) compared with medically managed NEC (27%, p<0.00001). The most common NDI in NEC was cerebral palsy (18%). Cerebral lesions: intraventricular haemorrhage (IVH) was more common in NEC babies (26%) compared with preterm infants (18%; p<0.0001). There was no difference in IVH incidence between infants with surgical NEC (25%) and those treated medically (20%; p=0.4). The incidence of periventricular leukomalacia (PVL) was significantly increased in infants with NEC (11%) compared with preterm infants (5%; p<0.00001).ConclusionsThis study shows that a large proportion of NEC survivors has NDI. NEC babies are at higher risk of developing IVH and/or PVL than babies with prematurity alone. The degree of NDI seems to correlate to the severity of gut damage, with a worse status in infants with surgical NEC compared with those with medical NEC.Trial registration numberCRD42019120522.

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“…Perinatal risk factors such as pregnancy induced hypertension; antepartum hemorrhage and placental infarction are also associated with impaired cerebrovascular autoregulation [29]. Other pathologies associated with impaired autoregulation include RDS [33] and necrotizing enterocolitis [40]. Infants who underwent surgical ligation of patent ductus arteriosus (PDA) were found to have more impaired autoregulation during the first 6 h after surgery compared to those with PDA treated conservatively with medication [32].…”

Section: Clinical Factorsmentioning

confidence: 99%

“…data averaged every hour) over longer measurement periods (i.e. 24 h) for cerebrovascular autoregulation assessment in preterm infants [40,42,56]. This is probably a rather rough method that may both overestimate and underestimate the infant's ability to adapt its arterioles to changes in ABP.…”

Section: Time-domain Analysismentioning

confidence: 99%

Measuring cerebrovascular autoregulation in preterm infants using near-infrared spectroscopy: an overview of the literature

Kooi¹,

Verhagen

Elting

et al. 2017

Expert Review of Neurotherapeutics

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(2017) Measuring cerebrovascular autoregulation in preterm infants using near-infrared spectroscopy: an overview of the literature, Expert Review of Neurotherapeutics, 17:8, 801-818, DOI: 10.1080/14737175.2017 Introduction:The preterm born infant's ability to regulate its cerebral blood flow (CBF) is crucial in preventing secondary ischemic and hemorrhagic damage in the developing brain. The relationship between arterial blood pressure (ABP) and CBF estimates, such as regional cerebral oxygenation as measured by near-infrared spectroscopy (NIRS), is an attractive option for continuous non-invasive assessment of cerebrovascular autoregulation. Areas covered: The authors performed a literature search to provide an overview of the current literature on various current clinical practices and methods to measure cerebrovascular autoregulation in the preterm infant by NIRS. The authors focused on various aspects: Characteristics of patient cohorts, surrogate measures for cerebral perfusion pressure, NIRS devices and their accompanying parameters, definitions for impaired cerebrovascular autoregulation, methods of measurements and clinical implications. Expert commentary: Autoregulation research in preterm infants has reported many methods for measuring autoregulation using different mathematical models, signal processing and data requirements. At present, it remains unclear which NIRS signals and algorithms should be used that result in the most accurate and clinically relevant assessment of cerebrovascular autoregulation. Future studies should focus on optimizing strategies for cerebrovascular autoregulation assessment in preterm infants in order to develop autoregulation-based cerebral perfusion treatment strategies. ARTICLE HISTORY

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Assessing cerebrovascular autoregulation in infants with necrotizing enterocolitis using near-infrared spectroscopy

Cited by 18 publications

References 33 publications

Current Research on the Epidemiology, Pathogenesis, and Management of Necrotizing Enterocolitis

Current Research on the Epidemiology, Pathogenesis, and Management of Necrotizing Enterocolitis

Neurodevelopmental impairment in necrotising enterocolitis survivors: systematic review and meta-analysis

Measuring cerebrovascular autoregulation in preterm infants using near-infrared spectroscopy: an overview of the literature

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