Abstract
BackgroundLittle is known about cerebral artery resistive index values in infants born extremely preterm.ObjectiveTo report resistive index values in various cerebral arteries in a prospective cohort of preterm infants born at <29 weeks’ gestation, and to compare resistive index in these arteries and assess the relationship between resistive index and hemodynamically significant patent ductus arteriosus.Materials and methodsUsing Doppler imaging, we obtained resistive index values of internal carotid arteries, basilar artery, anterior cerebral artery, and pial and striatal arteries in the first 3 days of age and weekly thereafter until discharge or death. We analyzed paired observations using the Wilcoxon signed-rank test, between-group comparisons with the Mann–Whitney test.ResultsWe performed 771 examinations in 235 infants. Resistive indices differed among arteries: vessels with larger diameters showed significantly higher resistive indices. Resistive index in infants without patent ductus arteriosus was lower than that in infants with hemodynamically significant patent ductus arteriosus (median in anterior cerebral artery: 0.75 and 0.82, respectively; P<0.001), though this was not statistically significant in all arteries. There was no difference in pre- and post-ligation resistive indices in infants who underwent patent ductus arteriosus ligation.ConclusionFor accurate follow-up and comparison of cerebral artery resistive index, the same artery should be examined on each occasion.
Highlights
Cerebral vascular anatomy and disturbance of cerebral hemodynamics are key factors in pathophysiology of brain injury in preterm infants [1]
The internal carotid artery, basilar artery, anterior cerebral artery and lenticulostriate arteries can be visualized with color Doppler imaging [2]
In current neonatal clinical practice, resistive index is typically assessed in the anterior cerebral artery in both term and preterm infants admitted to the neonatal intensive care unit
Summary
Cerebral vascular anatomy and disturbance of cerebral hemodynamics are key factors in pathophysiology of brain injury in preterm infants [1]. One such method assessing one aspect of cerebral blood flow is measuring resistive index in cerebral arteries using color Doppler imaging. Flow can be evaluated and peak systolic velocity, end-diastolic velocity and resistive index can be obtained. In current neonatal clinical practice, resistive index is typically assessed in the anterior cerebral artery in both term and preterm infants admitted to the neonatal intensive care unit. A patent ductus arteriosus is considered to be the usual cause for elevated resistive index in preterm infants [3]. Little is known about cerebral artery resistive index values in infants born extremely preterm
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