Cerebral oxygen saturation and autoregulation during hypotension in extremely preterm infants
The result's identifiers
Result code in IS VaVaI
<a href="https://www.isvavai.cz/riv?ss=detail&h=RIV%2F00023698%3A_____%2F21%3AN0000018" target="_blank" >RIV/00023698:_____/21:N0000018 - isvavai.cz</a>
Alternative codes found
RIV/00843989:_____/21:E0109199 RIV/00216208:11120/21:43921423 RIV/70883521:28150/21:63527778
Result on the web
<a href="https://doi.org/10.1038/s41390-021-01483-w" target="_blank" >https://doi.org/10.1038/s41390-021-01483-w</a>
DOI - Digital Object Identifier
<a href="http://dx.doi.org/10.1038/s41390-021-01483-w" target="_blank" >10.1038/s41390-021-01483-w</a>
Alternative languages
Result language
angličtina
Original language name
Cerebral oxygen saturation and autoregulation during hypotension in extremely preterm infants
Original language description
Background: The impact of the permissive hypotension approach in clinically well infants on regional cerebral oxygen saturation (rScO2) and autoregulatory capacity (CAR) remains unknown. Methods: Prospective cohort study of blinded rScO2 measurements within a randomized controlled trial of management of hypotension (HIP trial) in extremely preterm infants. rScO2, mean arterial blood pressure, duration of cerebral hypoxia, and transfer function (TF) gain inversely proportional to CAR, were compared between hypotensive infants randomized to receive dopamine or placebo and between hypotensive and non-hypotensive infants, and related to early intraventricular hemorrhage or death. Results: In 89 potentially eligible HIP trial patients with rScO2 measurements, the duration of cerebral hypoxia was significantly higher in 36 hypotensive compared to 53 non-hypotensive infants. In 29/36 hypotensive infants (mean GA 25 weeks, 69% males) receiving the study drug, no significant difference in rScO2 was observed after dopamine (n = 13) compared to placebo (n = 16). Duration of cerebral hypoxia was associated with early intraventricular hemorrhage or death. Calculated TF gain (n = 49/89) was significantly higher reflecting decreased CAR in 16 hypotensive compared to 33 non-hypotensive infants. Conclusions: Dopamine had no effect on rScO2 compared to placebo in hypotensive infants. Hypotension and cerebral hypoxia are associated with early intraventricular hemorrhage or death. Impact: Treatment of hypotension with dopamine in extremely preterm infants increases mean arterial blood pressure, but does not improve cerebral oxygenation.Hypotensive extremely preterm infants have increased duration of cerebral hypoxia and reduced cerebral autoregulatory capacity compared to non-hypotensive infants.Duration of cerebral hypoxia and hypotension are associated with early intraventricular hemorrhage or death in extremely preterm infants.Since systematic treatment of hypotension may not be associated with better outcomes, the diagnosis of cerebral hypoxia in hypotensive extremely preterm infants might guide treatment. © 2021, The Author(s), under exclusive licence to the International Pediatric Research Foundation, Inc. Reaxys Chemistry database informationLearn about Reaxys chemistry database information
Czech name
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Czech description
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Classification
Type
J<sub>imp</sub> - Article in a specialist periodical, which is included in the Web of Science database
CEP classification
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OECD FORD branch
30209 - Paediatrics
Result continuities
Project
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Continuities
R - Projekt Ramcoveho programu EK
Others
Publication year
2021
Confidentiality
S - Úplné a pravdivé údaje o projektu nepodléhají ochraně podle zvláštních právních předpisů
Data specific for result type
Name of the periodical
Pediatric Research
ISSN
0031-3998
e-ISSN
1530-0447
Volume of the periodical
90
Issue of the periodical within the volume
2
Country of publishing house
US - UNITED STATES
Number of pages
8
Pages from-to
373-380
UT code for WoS article
000641661500006
EID of the result in the Scopus database
2-s2.0-85105111800