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晚期早产儿和极早产儿转变为晚期早产儿过程中的脑近红外光谱模式。

Cerebral NIRS patterns in late preterm and very preterm infants becoming late preterm.

作者信息

Grometto Alice, Pizzo Benedetta, Strozzi Maria Chiara, Gazzolo Francesca, Gazzolo Diego

机构信息

a Faculty of Biology , University of Pavia , Pavia , Italy.

b Department of Maternal, Fetal and Neonatal Medicine , C. Arrigo Children's Hospital , Alessandria , Italy.

出版信息

J Matern Fetal Neonatal Med. 2019 Apr;32(7):1124-1129. doi: 10.1080/14767058.2017.1401605. Epub 2017 Nov 20.

Abstract

BACKGROUND

Near Infrared Spectroscopy (NIRS) has been proposed as a useful, noninvasive monitoring technique providing reliable information about central nervous system (CNS) oximetry and function. Recently, brain damage has been reconsidered as a dynamic process evolving over the weeks of gestation. We therefore investigated NIRS cerebral pattern differences between healthy late preterm infants (LPTo) and very preterm infants becoming late preterm (LPT).

METHODS

We conducted an observational study in 40 healthy late preterm infants, matched for gestational age at monitoring, of whom 20 where LPTo and 20 LPT. Clinical, diagnostic and laboratory monitoring procedures and cerebral oximetry (crSO) and function (cFTOE) were recorded on admission into the study.

RESULTS

No significant differences (p > .05, for all) were found between groups regarding clinical, diagnostic or laboratory parameters. Higher crSO and lower cFTOE (p < .001, for both) were found in the LPTo group.

CONCLUSIONS

Our results, showing impaired oximetry and function of CNS in LPT, offer additional support to NIRS parameters as a useful tool for longitudinal CNS monitoring of very preterm infants becoming LPT. Future studies correlating NIRS variables and long-term neurological outcome in LPT are needed to elucidate the concept of dynamic brain damage pathogenesis.

摘要

背景

近红外光谱技术(NIRS)已被提议作为一种有用的非侵入性监测技术,可提供有关中枢神经系统(CNS)血氧饱和度和功能的可靠信息。最近,脑损伤已被重新视为一个在孕周数周内不断发展的动态过程。因此,我们研究了健康晚期早产儿(LPTo)和极早产儿转为晚期早产儿(LPT)之间的NIRS脑模式差异。

方法

我们对40名健康晚期早产儿进行了一项观察性研究,这些婴儿在监测时孕周匹配,其中20名是LPTo,20名是LPT。在纳入研究时记录临床、诊断和实验室监测程序以及脑血氧饱和度(crSO)和功能(cFTOE)。

结果

两组在临床、诊断或实验室参数方面均未发现显著差异(所有p>0.05)。LPTo组的crSO较高,cFTOE较低(两者p<0.001)。

结论

我们的结果表明LPT中CNS的血氧饱和度和功能受损,为NIRS参数作为对极早产儿转为LPT进行中枢神经系统纵向监测的有用工具提供了额外支持。需要进一步研究LPT中NIRS变量与长期神经学结局之间的相关性,以阐明动态脑损伤发病机制的概念。

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