Schreiner Christina, Sappler Maria, Höck Michaela, Hammerl Marlene, Neubauer Vera, Kiechl-Kohlendorfer Ursula, Griesmaier Elke
Department of Pediatrics II (Neonatology), Medical University of Innsbruck, Innsbruck, Austria.
Front Pediatr. 2022 May 23;10:887614. doi: 10.3389/fped.2022.887614. eCollection 2022.
Prophylactic low-dose paracetamol administration is used to induce closure of the ductus arteriosus in preterm infants. In our recent study we found no impairment on microstructural maturation processes in the brain of preterm infants at term-equivalent age following prophylactic low-dose paracetamol administration. We now assessed amplitude-integrated electroencephalography (aEEG) signals in preterm infants with and without exposure to prophylactic low-dose paracetamol administration.
Infants <32 gestational weeks born between 10/2014 and 12/2018 received prophylactic paracetamol (10 mg/kg intravenously every 8 h until echocardiography after at least 72 h) and form the paracetamol group; infants born between 02/2011 and 09/2014 formed the control group. Four single parameters (continuity, cyclicity, amplitude of lower border, bandwidth span) together with their sum (Burdjalov total score) and presence of sleep-wake cycles were compared between the groups.
Included in the study were 338 infants. Two-hundred and seventeen infants received prophylactic paracetamol and 121 formed the control group. The paracetamol group showed a significantly higher number of sleep-wake cycles per hour and a significantly higher total scores compared to the control group ( < 0.05).
Paracetamol exposure has been regarded critically with respect to safety in preterm infants in recent years. We found no impairment on amplitude-integrated electroencephalography signals in preterm infants receiving low-dose prophylactic paracetamol compared to controls. Growing awareness and greater availability of data may encourage the clinicians to administer prophylactic paracetamol for ductal closure in preterm infants. The clinical relevance of our findings has to be evaluated in long-term follow up studies on neurodevelopmental outcome.
预防性给予低剂量对乙酰氨基酚用于诱导早产儿动脉导管闭合。在我们最近的研究中，我们发现，在足月等效年龄的早产儿中，预防性给予低剂量对乙酰氨基酚后，其大脑的微观结构成熟过程未受损害。我们现在评估了暴露于和未暴露于预防性低剂量对乙酰氨基酚的早产儿的振幅整合脑电图（aEEG）信号。
2014年10月至2018年12月出生的孕周<32周的婴儿接受预防性对乙酰氨基酚治疗（每8小时静脉注射10mg/kg，至少72小时后进行超声心动图检查），组成对乙酰氨基酚组；2011年2月至2014年9月出生的婴儿组成对照组。比较两组之间的四个单一参数（连续性、周期性、下限振幅、带宽跨度）及其总和（布尔贾洛夫总分）以及睡眠-觉醒周期的存在情况。
338名婴儿纳入研究。217名婴儿接受了预防性对乙酰氨基酚治疗，121名婴儿组成对照组。与对照组相比，对乙酰氨基酚组每小时的睡眠-觉醒周期数显著更多，总分也显著更高（<0.05）。
近年来，对乙酰氨基酚暴露在早产儿安全性方面受到了严格审视。我们发现，与对照组相比，接受低剂量预防性对乙酰氨基酚的早产儿的振幅整合脑电图信号未受损害。认识的提高和更多数据的可得性可能会鼓励临床医生对早产儿使用预防性对乙酰氨基酚来闭合动脉导管。我们研究结果的临床相关性必须在关于神经发育结局的长期随访研究中进行评估。
