Changes in cerebral oxygenation and hemodynamics during cranial ultrasound in preterm infants

• Published in: Brain & development (Tokyo. 1979) Vol. 31; no. 6; pp. 427 - 434
• Main Authors: van Alfen-van der Velden, Adriana A.E.M, Claessen, Vivian P.J, Hopman, Jeroen C.W, Klaessens, John H.G.M, Sengers, Rob C.A, Liem, Kian D
• Format: Journal Article
• Language: English
• Published: Netherlands Elsevier B.V 01.06.2009
• Subjects: Aging - metabolism; Analgesics, Opioid - pharmacology; Biomarkers - analysis; Biomarkers - metabolism; Blood supply; Brain; Brain - blood supply; Brain - growth & development; Brain - physiology; Cerebrovascular Circulation - physiology; Cranial Fontanelles - anatomy & histology; Cranial Fontanelles - physiology; Cranial ultrasonography; Echoencephalography - adverse effects; Echoencephalography - methods; Hemodynamics - physiology; Hemoglobins - analysis; Hemoglobins - metabolism; Humans; Hypnotics and Sedatives - pharmacology; Hypoxia, Brain - etiology; Hypoxia, Brain - physiopathology; Hypoxia, Brain - prevention & control; Iatrogenic Disease - prevention & control; Infant, Newborn; Infant, Premature - physiology; Intracranial Hypertension - complications; Intracranial Hypertension - etiology; Intracranial Hypertension - physiopathology; Midazolam - pharmacology; Morphine - pharmacology; Near infrared spectroscopy; Neurology; Oxygen Consumption - physiology; Premature infants; Pressure - adverse effects; Spectroscopy, Near-Infrared - methods; cO 2Hb; near infrared spectrophotometry; Near infrared spectroscopy; Brain; changes in concentration of deoxyhemoglobin; Premature infants; ctHb; cHbD; changes in concentration of total hemoglobin; Cranial ultrasonography; ultrasound; cHHb; cO 2Hb− cHHb; intracranial pressure; changes in concentration of oxyhemoglobin; CBV; cerebral blood volume; ICP; NIRS; US; Blood supply
• ISSN: 0387-7604; 1872-7131
• DOI: 10.1016/j.braindev.2008.08.002

Abstract Objectives: To evaluate whether application of a transducer on the anterior fontanelle during cranial ultrasound (US) examination effects cerebral hemodynamics and oxygenation in preterm infants. Study design∗ : During cranial US examination, changes in cerebral blood oxygenation ( c HbD) and cerebral blood volume (CBV) were assessed using near infrared spectrophotometry (NIRS) in 76 infants (GA 30.7 (4.1) wk, BW 1423 (717) g) within two days after birth. Ten of these infants (GA 29.1 (1.6) wk, BW 1092 (455) g) were studied again at a postnatal age of one week. Results∗ : We obtained stable and consistent NIRS registrations in 54 infants within the first two days after birth. Twenty-eight of these infants showed a decrease in c HbD (0.59 (0.54) μmol/100 g) during the scanning procedure while CBV did not change. Twenty-four infants showed no changes in NIRS and 2 infants showed an atypical NIRS response during cranial US examination. At the postnatal age of one week, stable and consistent NIRS registrations were obtained in 7 infants. None of these infants showed changes in NIRS variables during cranial US examination. Conclusions: Application of an US transducer on the anterior fontanelle causes changes in cerebral oxygenation and hemodynamics in a substantial number of preterm infants. ( ∗ values are expressed as median (interquartile range)).