Sidorenko Irina, Turova Varvara, Botkin Nikolai, Eckardt Laura, Alves-Pinto Ana, Felderhoff-Müser Ursula, Rieger-Fackeldey Esther, Kovtanyuk Andrey, Lampe Renée
Mathematical Faculty, Technical University of Munich, Garching, Germany.
Orthopedic Department, University Hospital Rechts der Isar, Technical University of Munich, Munich, Germany.
Front Neurol. 2018 Oct 9;9:812. doi: 10.3389/fneur.2018.00812. eCollection 2018.
Intraventricular hemorrhage () is one of the most critical complications in the development of preterm infants. The likelihood of is strongly associated with disturbances in cerebral blood flow () and with microvascular fragility in the germinal matrix (). The value and its reactivity to changes in arterial carbon dioxide pressure ( ) and mean arterial blood pressure () are relevant indicators in the clinical assessment of preterm infants. The objective of the present study is mathematical modeling of the influence of and on in immature brain, based on clinical data collected from 265 preterm infants with 23-30 gestational weeks. The model was adapted to the peculiarities of immature brain by taking into account the morphological characteristics of the capillary network and vascular reactivity, according to gestational and postnatal age. An analysis of model based values of and its reactivity to changes in and was performed separately for each gestational week and for the first two days of life both for preterm infants with and without . The developed model for the estimation of was validated against equivalent experimental measurements taken from the literature. A good agreement between the estimated values of , as well as its reaction on changes in and and the equivalent values obtained in experimental studies was shown.
脑室内出血（IVH）是早产儿发育过程中最严重的并发症之一。IVH的发生可能性与脑血流（CBF）紊乱以及生发基质（GM）中的微血管脆性密切相关。CBF值及其对动脉二氧化碳分压（PaCO₂）和平均动脉血压（MAP）变化的反应性是早产儿临床评估中的相关指标。本研究的目的是基于从265例孕周为23 - 30周的早产儿收集的临床数据，对未成熟脑内CBF和PaCO₂、MAP对IVH的影响进行数学建模。该模型根据孕周和出生后年龄，通过考虑GM毛细血管网络的形态特征和血管反应性，适应了未成熟脑的特点。分别针对每个孕周以及出生后头两天，对有和没有IVH的早产儿，分析基于模型的CBF值及其对PaCO₂和MAP变化的反应性。针对从文献中获取的等效实验测量值，对所开发的IVH估计模型进行了验证。结果表明，估计的CBF值及其对PaCO₂和MAP变化的反应与实验研究中获得的等效值之间具有良好的一致性。
