Cerebral Oxygenation in Preterm Infants With Germinal Matrix-Intraventricular Hemorrhages
Cerebral Oxygenation in Preterm Infants With Germinal Matrix-Intraventricular Hemorrhages
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DOI：
10.1161/strokeaha.110.597229
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发表时间：
2010-12-01
期刊：
影响因子：
8.3
通讯作者：
Bos, Arend F.
中科院分区：
文献类型：
--
作者：
Verhagen, Elise A.;ter Horst, Hendrik J.;Bos, Arend F.
背景和目的-早产儿有发生脑胶质瘤-脑室内瘤（GMH-IVH）的危险。脑灌注紊乱与GMH-IVH相关。计算用近红外光谱测量的局部脑组织氧饱和度（r（c）SO（2））和组织氧提取分数（FTOE），以获得脑灌注的指示。我们的目的是确定r（c）SO（2）和FTOE是否与早产儿GMH-IVH. Methods相关，该病例对照研究包括17名患有I至III级GMH-IVH或脑室周围出血性梗死的早产儿（中位胎龄，29.4周;范围，25.4至31.9周;出生体重，1260 g;范围，850至1840 g）。17例无GMH-IVH的早产儿，胎龄和出生体重匹配，作为对照组（胎龄，29.9周;范围，26.0至31.6周;出生体重，1310 g;范围，730至1975 g）。在出生后第1 - 5天、第8天和第15天，在2小时内测量R（c）SO（2）和经皮动脉血氧饱和度。FTOE的计算公式为FTOE=（经皮动脉血氧饱和度-r（c）SO（2））/经皮动脉血氧饱和度。结果-多水平分析显示，在第1、2、3、4、5、8和15天，GMH-IVH婴儿的r（c）SO（2）较低，FTOE较高。最大的差异发生在第5天，GMH-IVH婴儿的r（c）SO（2）中位数为64%，对照组为77%，FTOE中位数为0.30 vs 0.17。结论：GMH-IVH早产儿在出生后2周内，无论GMH-IVH的分级如何，r（c）SO（2）和FTOE均较低，而FTOE较高。这表明GMH-IVH婴儿的脑灌注持续减少2周，即使存在轻度脑梗塞。（中风。2010;41：2901-2907.）
Background and Purpose-Preterm infants are at risk of developing germinal matrix hemorrhages-intraventricular hemorrhages (GMH-IVH). Disturbances in cerebral perfusion are associated with GMH-IVH. Regional cerebral tissue oxygen saturation (r(c)SO(2)), measured with near-infrared spectroscopy, and fractional tissue oxygen extraction (FTOE) were calculated to obtain an indication of cerebral perfusion. Our objective was to determine whether r(c)SO(2) and FTOE were associated with GMH-IVH in preterm infants.Methods-This case-control study included 17 preterm infants with Grade I to III GMH-IVH or periventricular hemorrhagic infarction (median gestational age, 29.4 weeks; range, 25.4 to 31.9 weeks; birth weight, 1260 g; range, 850 to 1840 g). Seventeen preterm infants without GMH-IVH, matched for gestational age and birth weight, served as control subjects (gestational age, 29.9 weeks; range, 26.0 to 31.6 weeks; birth weight, 1310 g; range, 730 to 1975 g). R(c)SO(2) and transcutaneous arterial oxygen saturation were measured during 2 hours on Days 1 to 5, 8, and 15 after birth. FTOE was calculated as FTOE=(transcutaneous arterial oxygen saturation-r(c)SO(2))/transcutaneous arterial oxygen saturation.Results-Multilevel analyses showed that r(c)SO(2) was lower and FTOE higher in infants with GMH-IVH on Days 1, 2, 3, 4, 5, 8, and 15. The largest difference occurred on Day 5 with r(c)SO(2) median 64% in infants with GMH-IVH versus 77% in control subjects and FTOE median 0.30 versus 0.17. R(c)SO(2) and FTOE were not affected by the grade of GMH-IVH.Conclusions-Preterm infants with GMH-IVH had lower r(c)SO(2) and higher FTOE during the first 2 weeks after birth irrespective of the grade of GMH-IVH. This suggests that cerebral perfusion is decreased persistently for 2 weeks in infants with GMH-IVH, even in the presence of mild hemorrhages. (Stroke. 2010;41:2901-2907.)