Improving Infant Hydrocephalus Outcomes in Uganda: A Longitudinal Prospective Study Protocol for Predicting Developmental Outcomes and Identifying Patients at Risk for Early Treatment Failure after ETV/CPC.
Improving Infant Hydrocephalus Outcomes in Uganda: A Longitudinal Prospective Study Protocol for Predicting Developmental Outcomes and Identifying Patients at Risk for Early Treatment Failure after ETV/CPC.
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改善乌干达的婴儿脑积水结局：一种预测发育效果的纵向前瞻性研究方案，并确定ETV/CPC后有早期治疗衰竭风险的患者。
DOI：
10.3390/metabo12010078
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发表时间：
2022-01-14
期刊：
影响因子：
4.1
通讯作者：
Lin PY
中科院分区：
文献类型：
--
作者：
Vadset TA;Rajaram A;Hsiao CH;Kemigisha Katungi M;Magombe J;Seruwu M;Kaaya Nsubuga B;Vyas R;Tatz J;Playter K;Nalule E;Natukwatsa D;Wabukoma M;Neri Perez LE;Mulondo R;Queally JT;Fenster A;Kulkarni AV;Schiff SJ;Grant PE;Mbabazi Kabachelor E;Warf BC;Sutin JDB;Lin PY
婴儿脑积水造成严重的全球健康负担； 80% 的病例发生在发展中国家，患者获得神经外科护理的机会有限。结合内窥镜第三脑室造口术和脉络丛烧灼术 (ETV/CPC) 的手术治疗首先在乌干达 CURE 儿童医院 (CCHU) 实施，与标准脑室腹腔分流术 (VPS) 放置一样有效，同时需要更少的资源和术后护理。尽管治疗的重点是控制心室大小，但这与治疗失败或长期结果几乎没有关系。本研究旨在监测脑积水的进展和治疗反应，并研究手术后脑生理学、大脑生长和神经发育结果之间的关联。我们将招募 300 名入住 CCHU 的婴儿接受治疗。所有患者术前/术后均将使用频域近红外结合弥散相关光谱（FDNIRS-DCS）对脑组织氧合（SO2）、脑血流量（CBF）和脑耗氧代谢率（CMRO2）进行测量。婴儿还将接受脑部成像，以监测组织/心室容量以及神经发育评估，直到两岁。这项研究将为实施脑生理监测奠定基础，以建立脑积水治疗的循证指南。本文概述了这项国际多中心试验的方案、临床工作流程、数据管理和分析计划。
Infant hydrocephalus poses a severe global health burden; 80% of cases occur in the developing world where patients have limited access to neurosurgical care. Surgical treatment combining endoscopic third ventriculostomy and choroid plexus cauterization (ETV/CPC), first practiced at CURE Children’s Hospital of Uganda (CCHU), is as effective as standard ventriculoperitoneal shunt (VPS) placement while requiring fewer resources and less post-operative care. Although treatment focuses on controlling ventricle size, this has little association with treatment failure or long-term outcome. This study aims to monitor the progression of hydrocephalus and treatment response, and investigate the association between cerebral physiology, brain growth, and neurodevelopmental outcomes following surgery. We will enroll 300 infants admitted to CCHU for treatment. All patients will receive pre/post-operative measurements of cerebral tissue oxygenation (SO2), cerebral blood flow (CBF), and cerebral metabolic rate of oxygen consumption (CMRO2) using frequency-domain near-infrared combined with diffuse correlation spectroscopies (FDNIRS-DCS). Infants will also receive brain imaging, to monitor tissue/ventricle volume, and neurodevelopmental assessments until two years of age. This study will provide a foundation for implementing cerebral physiological monitoring to establish evidence-based guidelines for hydrocephalus treatment. This paper outlines the protocol, clinical workflow, data management, and analysis plan of this international, multi-center trial.
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影响因子：
3.2
作者：
Shang Y;Li T;Yu G
通讯作者：
Yu G
DOI：
10.3171/2011.12.peds11136
发表时间：
2012-03
期刊：
Journal of neurosurgery. Pediatrics
影响因子：
--
作者：
Robinson S
通讯作者：
Robinson S
影响因子：
6.3
作者：
Jain, Varsha;Buckley, Erin M.;Wehrli, Felix W.
通讯作者：
Wehrli, Felix W.
影响因子：
1.9
作者：
Mandell, Jason G.;Langelaan, Jack W.;Schiff, Steven J.
通讯作者：
Schiff, Steven J.
影响因子：
1.9
作者：
Marano, Paul J.;Stone, Scellig S. D.;Warf, Benjamin C.
通讯作者：
Warf, Benjamin C.