Impact of screening and treatment of low systemic blood flow in the prevention of severe intraventricular haemorrhage and/or death in pre-term infants

Erroz, Ignacio Oulego; Quintela, Paula Alonso; González, Aquilina Jiménez; Seara, S.; Blanco, S. Rodríguez; Varas, María Rosón; López, Leticia Castañón

doi:10.1016/j.anpede.2018.02.009

Cited by 5 publications

(5 citation statements)

References 43 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Most of these studies failed to identify a bene t from measuring and treating LSBF, but these studies were largely underpowered. 9,10,17 Recently, a large before-after single-center study of extremely preterm infants with a gestational age < 27 weeks showed that the implementation of early targeted neonatal echocardiography-guided hemodynamic management improved survival rates without high-grade IVH from 66-81%. 36 Our results are in line with this study.…”

Section: Resultsmentioning

confidence: 99%

“…[11][12][13][14] As a consequence, the use of inotropes to treat LSBF or even the clinical utility of measuring SVCf in daily practice remains controversial. 9,10,[15][16][17] Our prede ned hypothesis was that attaining a normal and stable SBF during the transitional period may preserve brain perfusion and contribute to preventing ischemic-reperfusion injury to the brain. Therefore, the objective of the present study was to assess whether early echocardiography screening for LSBF and guided inotropic therapy (abbreviated as ECHO) are associated with a reduced occurrence of IVH in preterm infants.…”

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Association between early echocardiography screening of low systemic blood flow and intraventricular hemorrhage in preterm infants: a multicenter cohort study

Terroba-Seara,

Oulego-Erroz,

Palanca-Arias

et al. 2024

J Perinatol

View full text Add to dashboard Cite

ObjectiveTo determine whether early screening for low systemic blood ow is associated with reduced intraventricular hemorrhage in preterm infants. Study designProspective, observational multicenter study in nine neonatal intensive care units. Preterm infants younger than 33 weeks of gestational age were eligible. The exposure was protocolized early echocardiography screening for low systemic blood ow. Our main outcome was ≥ grade II intraventricular hemorrhage or death within the rst 7 days of life. The main analysis used the inverse probability of treatment weighting based on propensity scores. Results332 preterm infants (131 in the intervention group and 201 in the control group) were included. Early echocardiography screening was associated with a signi cant reduction in ≥ grade II intraventricular hemorrhage or early death [odds ratio 0.285 (95% CI: 0.133-0.611); p = 0.001]. ConclusionsEarly echocardiography screening for low systemic blood ow may reduce the incidence of intraventricular hemorrhage in preterm infants.

show abstract

Section: Resultsmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Association between early echocardiography screening of low systemic blood flow and intraventricular hemorrhage in preterm infants: a multicenter cohort study

Terroba-Seara,

Oulego-Erroz,

Palanca-Arias

et al. 2024

J Perinatol

View full text Add to dashboard Cite

show abstract

“…There were no differences in PDA treatment or morbidity rates between the two epochs except for a decline in III-IV intraventricular hemorrhage that followed implementation of dobutamine treatment of low systemic blood ow in our unit. [22]…”

Section: Resultsmentioning

confidence: 99%

NT-PROBNP as a screening tool for low-risk patent ductus arteriousus: a follow-up validation study

López-Blanco,

Oulego-Erroz,

Pou-Blázquez

et al. 2023

Eur J Pediatr

View full text Add to dashboard Cite

Purpose: To test whether NT-proBNP serves as a screening for low-risk patent ductus arteriosus and safely avoids routine early echocardiography.Methods: Prospective observational study in preterm infants below 33 weeks of gestational age. Infants with >5100 pg/ml (positive screening) at 48-72 hours of life received comprehensive echocardiography and were treated according to shunt severity. Infants with NT-proBNP below 5100 pg/ml (negative screening) were managed expectantly. The main outcome was need for ductus treatment within the rst 7 days of life.Result: 125 infants were included; 82 had a negative and positive NT-proBNP screening respectively. No infant (0%) with a negative screening was treated for ductus while 26 (60.4%) with a positive screening were treated (p<0.001). NT-proBNP avoided a 65.6% of routine echocardiograms. NT-proBNP had an excellent performance to predict treatment (AUC=0.967) Conclusions: NT-proBNP at 48-72 hours of life has an excellent performance to detect low-risk and avoids unnecessary echocardiograms. This may contribute to optimize PDA management in terms of resource utilization.

show abstract

“…Most of these studies failed to identify a bene t from measuring and treating LSBF, but these studies were largely underpowered. [9,10,17] Recently, a large before-after single-center study in extremely preterm infants with a gestational age of <27 weeks showed that the implementation of early targeted neonatal echocardiography-guided hemodynamic management improved the survival rates without high-grade IVH from 66% to 81%. [37] Our results are in line with this study.…”

Section: Discussionmentioning

confidence: 99%

“…[11][12][13][14] As a consequence, the use of inotropes to treat LSBF or even measuring SVCf in clinical practice remain controversial. [9,10,[15][16][17] Our prede ned hypothesis was that attaining a normal and stable SBF during the transitional period may preserve brain perfusion and contribute to prevent ischemic brain injury. Therefore, the objective of the present study was to assess whether early echocardiography screening for LSBF and guided inotropic therapy (abbreviated as ECHO) is associated with a reduced occurrence of IVH in preterm infants.…”

Section: Introductionmentioning

confidence: 99%

Association Between Early Echocardiography Screening and Intraventricular Hemorrhage in Preterm Infants: A Prospective Observational Multicenter Study

Terroba-Seara,

Oulego-Erroz,

Palanca-Arias

et al. 2023

Preprint

View full text Add to dashboard Cite

Purpose:To determine whether the application of a protocolized early echocardiographic screening for low systemic blood flow and guided inotropic therapy is associated with reduced intraventricular hemorrhage in preterm infants. Methods: Prospective, observational multicenter study between September 2020 and September 2021 in nine neonatal intensive care units. Preterm infants below 33 weeks of gestational age were eligible. The exposure variable was early targeted neonatal echocardiography screening for low systemic blood flow. Five of the centers performed early screening and guided inotrope therapy (intervention group), and 4 centers did not (control group). Our main outcome was >grade II intraventricular hemorrhage or death within the first 7 days of life. Inverse probability of treatment weighting based on the propensity score accounting for the clustered nature of data was used for the main analysis. Results: 332 preterm infants (131 in the intervention group and 201 in thecontrol group) were included. Protocolized early echocardiography screening for low systemic blood flow and guided inotropic treatment was associated with a significant reduction in > grade II intraventricular hemorrhage or early death (odds ratio 0.285 (95% CI: 0.133-0.611); p=0.001) Conclusions: Early echocardiography screening for low systemic blood flow and guided inotropic treatment may reduce the incidence of intraventricular hemorrhage in preterm infants.

show abstract

Impact of screening and treatment of low systemic blood flow in the prevention of severe intraventricular haemorrhage and/or death in pre-term infants

Cited by 5 publications

References 43 publications

Association between early echocardiography screening of low systemic blood flow and intraventricular hemorrhage in preterm infants: a multicenter cohort study

Association between early echocardiography screening of low systemic blood flow and intraventricular hemorrhage in preterm infants: a multicenter cohort study

NT-PROBNP as a screening tool for low-risk patent ductus arteriousus: a follow-up validation study

Association Between Early Echocardiography Screening and Intraventricular Hemorrhage in Preterm Infants: A Prospective Observational Multicenter Study

Contact Info

Product

Resources

About