Journal article
Combined Multimodal Cerebral Monitoring and Focused Hemodynamic Assessment in the First 72 h in Extremely Low Gestational Age Infants
Neonatology (Basel, Switzerland), Vol.117(4), pp.504-512
12/01/2020
DOI: 10.1159/000508961
PMID: 32814317
Abstract
Background: Characteristic changes in cerebral saturation (CrSO2), amplitude-integrated electroencephalography (aEEG), and echocardiography (ECHO) may be associated with intraventricular hemorrhage (IVH); however, the feasibility of their combined application is not known. Objective: The aim of this work was to investigate the feasibility and safety of combined multimodal cerebral and hemodynamic monitoring in extremely low gestational age (ELGA) infants in the first 72 h after birth. Methods: In this prospective -observational study of 50 infants born between 23 + 0 and 27 + 6 weeks gestation, we measured CrSO2 and aEEG, starting <8 h until 72 h of age. Sequential echocardiography and head ultrasound were performed at 4-8, 12-18, 24-30, and 48-60 h of age. The primary outcome was feasibility of multimodal monitoring, defined as >75% of the subjects satisfying at least 3/4 criteria: (a) CrSO2 and (b) aEEG monitoring each for >75% of the time, and (c) at least 2 out of 4 ECHO and (d) head ultrasounds (at least one by age 24 h). Adverse reactions to sensors, desaturation, and bradycardia during ultrasound studies were recorded. Results: Fifty infants were enrolled over 14 months. Multimodal monitoring was feasible in 49 (98%) infants. Forty-one (82%) infants fulfilled all 4 criteria. Mild erythema below CrSO2 sensors lasting 3-8 h without skin breakdown was noted in 8/50 subjects (16%). Desaturation was noted during 17/197 (8.6%) of the ultrasound studies. In total, 26/50 (52%) infants developed IVH (grade I/II, n = 22; grade III/IV, n = 4). Conclusion: Multimodal monitoring is feasible, safe, and well tolerated in ELGA infants in the first 72 h after birth.
Details
- Title: Subtitle
- Combined Multimodal Cerebral Monitoring and Focused Hemodynamic Assessment in the First 72 h in Extremely Low Gestational Age Infants
- Creators
- Poorva Deshpande - University of TorontoAmish Jain - University of TorontoDaniel Ibarra Rios - Hospital for Sick ChildrenSoume Bhattacharya - Hospital for Sick ChildrenJulia Dirks - Mental Health Research CanadaMichelle Baczynski - Mount Sinai HospitalKarl P. McNamara - Hospital for Sick ChildrenCecil Hahn - Hospital for Sick ChildrenPatrick J. McNamara - University of TorontoPrakesh Shah - University of TorontoAnne-Marie Guerguerian - Hospital for Sick Children
- Resource Type
- Journal article
- Publication Details
- Neonatology (Basel, Switzerland), Vol.117(4), pp.504-512
- Publisher
- Karger
- DOI
- 10.1159/000508961
- PMID
- 32814317
- ISSN
- 1661-7800
- eISSN
- 1661-7819
- Number of pages
- 9
- Grant note
- Michael Braudo foundation
- Language
- English
- Date published
- 12/01/2020
- Academic Unit
- Stead Family Department of Pediatrics; Neonatology; Internal Medicine
- Record Identifier
- 9984353935502771
Metrics
16 Record Views