title: Cerebral blood volume changes during closure by surgery of patent ductus arteriosus.
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.
  
  
  METHODS
  Continuous cerebral near-infrared spectroscopy (NIRS) recording throughout PDA surgery.
  
  
  METHODS
  Tertiary neonatal intensive care unit, with PDA surgery performed on the ward.
  
  
  METHODS
  Ten VLBW infants, median birth weight 748 g (range 590-1070), gestational age 24 (23-27) weeks, chronological age 14 (12-22) days.
  
  
  METHODS
  Surgical closure of PDA.
  
  
  METHODS
  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.
authors.affiliation: Department of Paediatrics, Essen University Hospital, Essen,Germany.
authors.forename: B M
authors.initials: BM
authors.lastname: Hüning
authors.forename: B
authors.initials: B
authors.lastname: Asfour
authors.forename: S
authors.initials: S
authors.lastname: König
authors.forename: N
authors.initials: N
authors.lastname: Hess
authors.forename: C
authors.initials: C
authors.lastname: Roll
mesh_terms: D001810:Blood Volume / Q000502:physiology*; D001921:Brain / Q000098:blood supply*; D002560:Cerebrovascular Circulation / Q000502:physiology; D004374:Ductus Arteriosus, Patent / Q000378:metabolism / Q000503:physiopathology* / Q000601:surgery; D006339:Heart Rate; D006454:Hemoglobins / Q000378:metabolism*; D006801:Humans; D007231:Infant, Newborn; D019102:Infant, Very Low Birth Weight / Q000502:physiology; D010100:Oxygen / Q000097:blood*; D019265:Spectroscopy, Near-Infrared
chemical_list: D006454:Hemoglobins; D010100:Oxygen