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Arch Dis Child Fetal Neonatal Ed. 2008 Jul;93(4):F261-4. doi: 10.1136/adc.2007.121715. Epub 2008 Feb 5.

Cerebral blood volume changes during closure by surgery of patent ductus arteriosus.

Author information

1
Department of Paediatrics, Essen University Hospital, Essen,Germany.

Abstract

BACKGROUND:

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.

OBJECTIVE:

To examine the cerebral blood volume changes occurring after surgical closure of PDA.

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, median birth weight 748 g (range 590-1070), gestational age 24 (23-27) weeks, chronological age 14 (12-22) days.

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 NIRS.

RESULTS:

During the first 2 minutes after closure of the PDA, CBV increased significantly (mean (SD) 0.14 (0.12) ml/100 g tissue; p = 0.01) and returned to baseline within 2-5 minutes. Cerebral oxygenation did not change.

CONCLUSIONS:

There is a short-lasting increase in CBV immediately after surgical closure of PDA, but no change in cerebral oxygenation. These transient changes are unlikely to cause harm.

PMID:
18252817
DOI:
10.1136/adc.2007.121715
[Indexed for MEDLINE]

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