Transfontanellar duplex brain ultrasonography resistive indices as a prognostic tool in neonatal hypoxic-ischemic encephalopathy before and after treatment with therapeutic hypothermia

被引：22

作者：

Gerner, G. J. ^{[1
,2
]}

Burton, V. J. ^{[2
,3
]}

Poretti, A. ^{[2
,4
]}

Bosemaniz, T. ^{[2
,4
]}

Cristofalo, E. ^{[2
,3
,5
]}

Tekes, A. ^{[2
,4
]}

Seyfert, D. ^{[4
]}

Parkinson, C. ^{[2
,5
]}

Leppert, M.

Allen, M. ^{[2
,3
,5
]}

Huisman, T. A. G. M. ^{[2
,4
]}

Northington, F. J. ^{[2
,5
]}

Johnston, M. V. ^{[2
,3
,6
,7
]}

机构：

[1] Kennedy Krieger Inst, Dept Neuropsychol, 1750 E Fairmount Ave, Baltimore, MD 21231 USA

[2] Johns Hopkins Univ, Sch Med, Neurosci Intens Care Nursery, Baltimore, MD USA

[3] Kennedy Krieger Inst, Neurol & Dev Med, Baltimore, MD USA

[4] Johns Hopkins Univ, Sch Med, Russell H Morgan Dept Radiol & Radiol Sci, Sect Pediat Neuroradiol,Div Pediat Radiol, Baltimore, MD USA

[5] Johns Hopkins Univ, Sch Med, Dept Pediat, Div Perinatal Neonatal Med, Baltimore, MD 21205 USA

[6] Kennedy Krieger Inst, Hugo Moser Res Inst, Baltimore, MD USA

[7] Johns Hopkins Univ, Sch Med, Dept Neurol, Baltimore, MD 21205 USA

来源：

JOURNAL OF PERINATOLOGY | 2016年 / 36卷 / 03期

关键词：

CEREBRAL RESISTANCE INDEX; AUTOREGULATION; ASPHYXIA;

D O I：

10.1038/jp.2015.169

中图分类号：

R71 [妇产科学];

学科分类号：

100211 ;

摘要：

OBJECTIVE: Prior to therapeutic hypothermia (that is, cooling), transfontanellar duplex brain sonography resistive indices (RI) were studied as a bedside non-invasive measures of cerebral hemodynamics in neonates who suffered from hypoxic-ischemic encephalopathy (HIE). We compared pre- and post-cooling RI values and examined the relationships between RI values and specific long-term neurodevelopmental outcomes. STUDY DESIGN: Transfontanellar duplex brain sonography, including RI, were obtained for 28 neonates prior to cooling and for 20 neonates following cooling. All RI values were sampled in the anterior cerebral artery at the beginning of each ultrasound study. Neurodevelopmental assessment was conducted between ages 20-32 months with the Mullen Scale of Early Learning. The relationships between pre- and post-cooling RI and cognitive and motor outcomes were studied. RESULT: Neonates with RI values < 0.60 prior to and following cooling were more likely to die or have severe neurodevelopmental disability by ages 20-32 months than those with RI >0.60. Lower RI values were associated with specific neurodevelopmental deficits in motor skill attainment. CONCLUSION: Pre- and post-cooling transfontanellar duplex brain sonography RI values may be a useful prognostic tool, in conjunction with other clinical information, for neonates diagnosed with HIE. The results of this study suggest that further study of the prognostic value of RI values for short- and long-term outcomes is warranted.

引用

页码：202 / 206

页数：5

共 28 条

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