Division of Neonatology, Beatrix Children's Hospital, University of Groningen, University Medical Center Groningen, The Netherlands.
Division of Neonatology, Beatrix Children's Hospital, University of Groningen, University Medical Center Groningen, The Netherlands.
Clin Neurophysiol. 2014 Jan;125(1):47-52. doi: 10.1016/j.clinph.2013.07.001. Epub 2013 Aug 22.
Our aim was to explore clinical parameters that might predict the absence of cerebrovascular autoregulation (CAR) assessed by a negative relationship between mean arterial blood pressure (MABP) and fractional tissue oxygen extraction (FTOE) as measured by near-infared spectroscopy (NIRS) in preterm infants.
We included preterm infants (gestational age (GA) <32 weeks). Within 72 h after birth, we recorded the infants' NIRS parameters and MABP for a 24-h period. Fractional tissue oxygen extraction (FTOE) was calculated. For each infant we calculated Spearman rank (rho) correlations. A statistically significant negative correlation between MABP and FTOE indicated the absent CAR. We related the absent CAR to clinical parameters.
Ten (40%) out of 25 infants (median GA 29.1 weeks, range 25.4-31.7, birth weight 1245 g, 560-1780) had a statistically significant negative correlation between MABP and FTOE (rho -0.432 to -0.156), suggesting the absence of CAR. None of the clinical variables predicted the absence of CAR.
We were unable to predict the absence of CAR in terms of clinical variables. Nevertheless, we found a statistically significant negative correlation between MABP and FTOE using NIRS, suggesting the absence of CAR in almost half of the preterm infants studied.
NIRS could be a helpful tool to assess the presence or absence of CAR.
我们旨在探索临床参数，这些参数可能预示着通过近红外光谱（NIRS）测量的平均动脉血压（MABP）和组织氧提取分数（FTOE）之间的负相关关系评估的脑血管自动调节（CAR）缺失，该参数适用于早产儿。
我们纳入了早产儿（胎龄（GA）<32 周）。在出生后 72 小时内，我们记录了婴儿的 NIRS 参数和 24 小时的 MABP。计算了组织氧提取分数（FTOE）。对于每个婴儿，我们计算了 Spearman 秩相关系数（rho）。MABP 和 FTOE 之间存在统计学上显著的负相关表明 CAR 缺失。我们将缺失的 CAR 与临床参数联系起来。
25 名婴儿中有 10 名（40%）（中位 GA 为 29.1 周，范围为 25.4-31.7，出生体重为 1245g，范围为 560-1780g）MABP 和 FTOE 之间存在统计学上显著的负相关（rho 值为-0.432 至-0.156），提示 CAR 缺失。没有任何临床变量可以预测 CAR 的缺失。
我们无法根据临床变量预测 CAR 的缺失。尽管如此，我们使用 NIRS 发现 MABP 和 FTOE 之间存在统计学上显著的负相关，这表明研究中的近一半早产儿存在 CAR 缺失。
NIRS 可能是评估 CAR 存在或缺失的有用工具。
