2nd Department of Neonatology, Papageorgiou Hospital, Aristotle University of Thessaloniki, Thessaloniki, Greece; Imperial College Healthcare NHS Trust, London, UK.
2nd Department of Neonatology, Papageorgiou Hospital, Aristotle University of Thessaloniki, Thessaloniki, Greece.
Early Hum Dev. 2019 Sep;136:49-53. doi: 10.1016/j.earlhumdev.2019.07.008. Epub 2019 Jul 13.
Neonatal sepsis has been associated with poor neurodevelopmental outcome, however the evidence regarding the exact mechanism of the inflammation to the developing neonatal brain are inconclusive.
To investigate association between cerebral oxygenation during neonatal sepsis and neurodevelopmental outcome.
Follow-up assessment of a previously described prospective case-control study.
A cohort of late preterm (34-37 weeks' gestation) and preterm (<34 weeks' gestation) infants with sepsis and healthy controls, evaluated at 18-24 months of corrected gestational age with Bayley-III Scales for Infant and Toddler Development (BSID-III).
To evaluate the association between cerebral tissue oxygenation index (cTOI) and fractional tissue oxygen extraction (FTOE), measured with near-infrared spectroscopy, during sepsis and the composite cognitive and motor index scores.
Thirty-one infants with blood culture confirmed neonatal sepsis and thirty-five controls were recruited. The cerebral oxygenation was significantly lower in septic neonates, compared to controls (61 ± 7 compared to 72 ± 5; p < 0.001). Infants with sepsis had significantly lower cognitive and motor index scores and higher proportion of suboptimal cognitive (16% compared to 3%, p = 0.045) and motor (16% compared to none, p = 0.008) index score. The low mean cTOI and FTOE noted in septic infants were significantly associated with worse cognitive and motor composite index scores.
Infants with lower cerebral oxygenation during neonatal sepsis are at increased risk of worse cognitive and motor scores in the neurodevelopmental assessment.
新生儿败血症与不良神经发育结局相关，但炎症对新生儿大脑发育的确切机制的证据尚无定论。
研究新生儿败血症期间脑氧合与神经发育结局之间的关系。
对先前描述的前瞻性病例对照研究进行随访评估。
一组晚期早产儿（34-37 周胎龄）和早产儿（<34 周胎龄）败血症患儿和健康对照组，在纠正胎龄 18-24 个月时用贝利婴幼儿发育量表第三版（BSID-III）进行评估。
评估败血症期间近红外光谱测量的脑氧合指数（cTOI）和组织氧摄取分数（FTOE）与复合认知和运动指数评分之间的关系。
共招募了 31 例血培养确诊的新生儿败血症和 35 例对照。与对照组相比，败血症患儿的脑氧合明显更低（61±7 与 72±5；p<0.001）。败血症患儿的认知和运动指数评分明显较低，且认知和运动指数评分不理想的比例更高（16%比 3%，p=0.045）和运动（16%比无，p=0.008）。败血症患儿中 cTOI 和 FTOE 的平均水平较低，与认知和运动复合指数评分较差显著相关。
新生儿败血症期间脑氧合较低的婴儿在神经发育评估中认知和运动评分较差的风险增加。
