Changes in cerebral oxygenation and hemodynamics during cranial ultrasound in preterm infants.
OBJECTIVE
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 (cHbD) 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 cHbD (0.59 (0.54) micromol/100g) 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)).
Subdivision of Neonatology, Department of Pediatrics, Radboud University, Nijmegen Medical Centre, Nijmegen, The Netherlands.
Adriana A E M
AA
van Alfen-van der Velden
Vivian P J
VP
Claessen
Jeroen C W
JC
Hopman
John H G M
JH
Klaessens
Rob C A
RC
Sengers
Kian D
KD
Liem
D000375:Aging / Q000378:metabolism; D000701:Analgesics, Opioid / Q000494:pharmacology; D015415:Biomarkers / Q000032:analysis / Q000378:metabolism; D001921:Brain / Q000098:blood supply / Q000254:growth & development / Q000502:physiology*; D002560:Cerebrovascular Circulation / Q000502:physiology*; D055762:Cranial Fontanelles / Q000033:anatomy & histology / Q000502:physiology; D004453:Echoencephalography / Q000009:adverse effects* / Q000379:methods; D006439:Hemodynamics / Q000502:physiology; D006454:Hemoglobins / Q000032:analysis / Q000378:metabolism; D006801:Humans; D006993:Hypnotics and Sedatives / Q000494:pharmacology; D002534:Hypoxia, Brain / Q000209:etiology / Q000503:physiopathology / Q000517:prevention & control; D007049:Iatrogenic Disease / Q000517:prevention & control; D007231:Infant, Newborn; D007234:Infant, Premature / Q000502:physiology*; D019586:Intracranial Hypertension / Q000150:complications / Q000209:etiology / Q000503:physiopathology; D008874:Midazolam / Q000494:pharmacology; D009020:Morphine / Q000494:pharmacology; D010101:Oxygen Consumption / Q000502:physiology*; D011312:Pressure / Q000009:adverse effects; D019265:Spectroscopy, Near-Infrared / Q000379:methods*
D000701:Analgesics, Opioid; D015415:Biomarkers; D006454:Hemoglobins; D006993:Hypnotics and Sedatives; D009020:Morphine; D008874:Midazolam