Decreased Cerebral Oxygenation in Premature Infants with Progressive Posthemorrhagic Ventricular Dilatation May Help with Timing of Intervention

2021 ◽  
Author(s):  
Angelina June ◽  
Timothy Heck ◽  
Tushar A. Shah ◽  
Turaj Vazifedan ◽  
William Thomas Bass
Keyword(s):  
Premature Infants ◽  
Near Infrared ◽  
Linear Models ◽  
Cerebral Oxygenation ◽  
Strong Predictor ◽  
Ventricular Dilatation ◽  
Study Cohort ◽  
Cranial Ultrasound ◽  
Severe Group ◽  
Grade 3

Objective The objective of this study was to determine the degree of progressive posthemorrhagic ventricular dilatation (PHVD) that is associated with a significant decrease in regional cerebral oxygen saturation (rScO2) in premature infants at risk for periventricular–intraventricular hemorrhage (PIVH). Study Design Cranial ultrasound (US) and near-infrared spectroscopy (NIRS) measurements of rScO2 were performed on inborn infants with birth weights less than 1,250 g on admission and at 1, 4, and 8 weeks of age. Infants with severe PIVH were studied weekly. A 1-hour average of rScO2 was compared with the frontal–occipital horn ratio (FOHR) measured the same day. Generalized linear models were used to analyze the relationship between FOHR and rScO2, by severity of PIVH, and adjusted for gestational age. Cut-off points of 0.55 for FOHR and 45% for rScO2 were used to calculate odds ratios (OR) and 95% confidence intervals (CI). Results The study cohort included 63 infants with normal US, 15 with grade-1 or -2 PIVH (mild group), and 21 with grade-3 or -4 PIVH (severe group). Increases in FOHR in the severe group were associated with decreases in rScO2 at 1 week (p = 0.036), 4 weeks (p = 0.013), and 8 weeks of life (p = 0.001) compared with the normal and mild groups. Infants with FOHR greater than 0.55 were 92% more likely to have rScO2 less than 45% when compared with infants with FOHR less than 0.55 (OR = 0.08, 95% CI: [0.04, 0.13], p < 0.001). Conclusion Progressive PHVD (FOHR > 0.55) is a strong predictor of compromised cerebral oxygenation. A combination of rScO2 and FOHR measurements may aid in identifying infants with PHVD that would benefit from early intervention. Key Points

Quantitative cranial ultrasound prediction of severity of disability in premature infants with post-haemorrhagic ventricular dilatation

2012 ◽  
Vol 97 (11) ◽  
pp. 955-959 ◽  
Author(s):  
Sally Jary ◽  
Grazyna Kmita ◽  
Jolanta Wroblewska ◽  
Andrew Whitelaw
Keyword(s):  
Premature Infants ◽  
Infant Development ◽  
Neurodevelopmental Outcome ◽  
Intraventricular Haemorrhage ◽  
Ventricular Dilatation ◽  
Cranial Ultrasound ◽  
Vp Shunt ◽  
Motor Disability ◽  
Parenchymal Lesion ◽  
Grade 3

BackgroundInfants with post-haemorrhagic ventricular dilatation (PHVD) have a high risk of severe disability and parenchymal infarction increases this risk. Existing cranial ultrasound (CUS) markers of neurodevelopmental outcome are based on categorical features.ObjectiveTo investigate to what extent quantitative CUS measurements correlated with severity of developmental outcome and the need for ventriculoperitoneal (VP) shunt at 2 years of age.Design69 premature infants with PHVD had lateral ventricle area, intraventricular echodensity and parenchymal lesion dimensions measured at the start of treatment for PHVD. Outcome measures were the Bayley Scales of Infant Development-II and functional ability at 2 years of age. Bayley developmental quotients (DQ) were used in preference to index scores to enable inclusion of severely disabled children.ResultsQuantitative CUS measurements of parenchymal lesion area correlated significantly with later mental and motor DQ. Intraventricular echodensity area correlated with motor DQ in infants with grade 4 intraventricular haemorrhage (IVH). Neither ventricular area nor ventricular width correlated with DQ in grade 3 IVH. Infants who ultimately required a VP shunt had a significantly larger intraventricular echodensity area.ConclusionsCUS measurement of parenchymal lesions in infants with PHVD can increase the precision of predicting severe mental and motor disability, but ventricular size at the start of treatment is not predictive of outcome in infants with PHVD following grade 3 IVH.

scholarly journals Association between early cerebral oxygenation and neurodevelopmental impairment or death in premature infants

2021 ◽  
Vol 41 (4) ◽  
pp. 743-748
Author(s):  
Anup C. Katheria ◽  
Jacob Stout ◽  
Ana L. Morales ◽  
Debra Poeltler ◽  
Wade D. Rich ◽  
...  
Keyword(s):  
Premature Infants ◽  
Cerebral Oxygenation ◽  
Neurodevelopmental Impairment

scholarly journals Cognitive, physical and disability trajectories in community-dwelling elderly people

2021 ◽  
Author(s):  
Ottavia Eleonora Ferraro ◽  
Antonio Guaita ◽  
Simona Villani
Keyword(s):  
Physical Function ◽  
Cumulative Incidence ◽  
Female Gender ◽  
Community Dwelling ◽  
Study Cohort ◽  
Carrier Status ◽  
Speed Test ◽  
Health Trajectories ◽  
Severe Group ◽  
Incidence Of Dementia

Abstract Backgrounds and aims Health trajectories in aging, rather than single time-point assessments, could be early indicators of the onset of conditions such as dementia. The aim of this study was to identify different aging trajectories and to investigate their influence on the cumulative incidence of dementia. Methods We evaluated data referring to 993 elders from the InveCe.Ab study cohort. All subjects were free from dementia at baseline and re-assessed on at least one other occasion thereafter. Cognitive function was assessed using the Mini-Mental State Examination (MMSE), physical function using the Walking Speed Test (WST), and disability on the basis of the Activities of Daily Living (ADL) score. To describe the different courses of the three outcomes combined, the Group-Based Trajectory Model (GBTM) method was applied. We looked for differences in age, gender, education, ApoE-e4 carrier status and obesity, and then investigated the influence of the observed trajectories on the incidence of dementia. Results Three trajectories were identified: a “good” scenario was observed in 703 (70.2%) individuals, who showed substantially stable cognitive and physical function and no disability; an “intermediate” scenario in 248 subjects (25.5%), who recorded a longer walking time, lower MMSE score, and a one-point higher ADL score; and a “severe” scenario in 42 elders (4.3%), who recorded declines in all the outcomes. Female gender, obesity and low education were most represented in the “severe” group. ApoE-e4 carrier status showed no difference between groups. The estimated cumulative incidence of dementia was higher in the “severe” (37%) than in the “intermediate” (7%) and “good” (< 1%) scenarios. Conclusions Using simple measurements, we built different aging trajectories, and observed that the worst performers had the highest incidence of dementia. Better knowledge of trajectories of aging would be useful for preventive interventions aimed at promoting healthier aging.

Continuous Measurement of Cerebral Oxygenation by Near Infrared Spectroscopy During Induction of Anesthesia

1999 ◽  
Vol 88 (3) ◽  
pp. 554-558 ◽  
Author(s):  
A. Timothy Lovell ◽  
Huw Owen-Reece ◽  
Clare E. Elwell ◽  
Martin Smith ◽  
John C. Goldstone
Keyword(s):  
Infrared Spectroscopy ◽  
Near Infrared Spectroscopy ◽  
Near Infrared ◽  
Continuous Measurement ◽  
Cerebral Oxygenation

scholarly journals Influence of Intravenous Sildenafil on Cerebral Oxygenation Measured by Near-Infrared Spectroscopy in Infants After Cardiac Surgery

2006 ◽  
Vol 59 (3) ◽  
pp. 462-465 ◽  
Author(s):  
Nicole Nagdyman ◽  
Thilo Fleck ◽  
Birgit Bitterling ◽  
Peter Ewert ◽  
Hashim Abdul-Khaliq ◽  
...  
Keyword(s):  
Cardiac Surgery ◽  
Infrared Spectroscopy ◽  
Near Infrared Spectroscopy ◽  
Near Infrared ◽  
Cerebral Oxygenation

scholarly journals Elderly Taiwanese who spend more on fruits and vegetables and less on animal-derived foods use less medical services and incur lower medical costs

2016 ◽  
Vol 115 (5) ◽  
pp. 823-833 ◽  
Author(s):  
Yuan-Ting C. Lo ◽  
Mark L. Wahlqvist ◽  
Yi-Chen Huang ◽  
Meei-Shyuan Lee
Keyword(s):  
Older Adults ◽  
Fruits And Vegetables ◽  
Medical Service ◽  
Linear Models ◽  
Medical Costs ◽  
Food Group ◽  
Study Cohort ◽  
Service Utilisation ◽  
Medical Care System ◽  
Hospital Days

AbstractA higher intake of fruits and vegetables (F&V) compared with animal-derived foods is associated with lower risks of all-cause-, cancer- and CVD-related mortalities. However, the association between consumption patterns and medical costs remains unclear. The effects of various food group costs on medical service utilisation and costs were investigated. The study cohort was recruited through the Elderly Nutrition and Health Survey in Taiwan between 1999 and 2000 and followed-up for 8 years until 2006. It comprised free-living elderly participants who provided a 24-h dietary recall. Daily energy-adjusted food group costs were estimated. Annual medical service utilisation and costs for 1445 participants aged 65–79 years were calculated from the National Health Insurance claim data. Generalised linear models were used to appraise the associations between the food group costs and medical service utilisation and costs. Older adults with the highest F&V cost tertile had significantly fewer hospital days (30 %) and total medical costs (19 %), whereas those in the highest animal-derived group had a higher number of hospital days (28 %) and costs (83 %) as well as total medical costs (38 %). Participants in the high F&V and low animal-derived cost groups had the shortest annual hospitalisation stays (5·78 d) and lowest costs (NT$38 600) as well as the lowest total medical costs (NT$75 800), a mean annual saving of NT$45 200/person. Older adults who spend more on F&V and less on animal-derived foods have a reduced medical-care system burden. This provides opportunities for nutritionally related healthcare system investment strategies.

Near-Infrared Spectroscopy Monitoring of Cerebral Oxygenation and Influencing Factors in Neonates from High-Altitude Areas

Neonatology ◽  
2021 ◽  
pp. 1-6
Author(s):  
Bi Ze ◽  
Lili Liu ◽  
Ge Sang Yang Jin ◽  
Minna Shan ◽  
Yuehang Geng ◽  
...  
Keyword(s):  
Heart Disease ◽  
Infrared Spectroscopy ◽  
Brain Injury ◽  
Oxygen Saturation ◽  
High Altitude ◽  
Near Infrared Spectroscopy ◽  
Near Infrared ◽  
Cerebral Oxygenation ◽  
Low Altitude ◽  
Normal Neonates

<b><i>Background:</i></b> Accurate detection of cerebral oxygen saturation (rSO<sub>2</sub>) may be useful for neonatal brain injury prevention, and the normal range of rSO<sub>2</sub> of neonates at high altitude remained unclear. <b><i>Objective:</i></b> To compare cerebral rSO<sub>2</sub> and cerebral fractional tissue oxygen extraction (cFTOE) at high-altitude and low-altitude areas in healthy neonates and neonates with underlying diseases. <b><i>Methods:</i></b> 515 neonates from low-altitude areas and 151 from Tibet were enrolled. These neonates were assigned into the normal group, hypoxic-ischemic encephalopathy (HIE) group, and other diseases group. Near-infrared spectroscopy was used to measure rSO<sub>2</sub> in neonates within 24 h after admission. The differences of rSO<sub>2</sub>, pulse oxygen saturation (SpO<sub>2</sub>), and cFTOE levels were compared between neonates from low- and high-altitude areas. <b><i>Results:</i></b> (1) The mean rSO<sub>2</sub> and cFTOE levels in normal neonates from Tibet were 55.0 ± 6.4% and 32.6 ± 8.5%, significantly lower than those from low-altitude areas (<i>p</i> &#x3c; 0.05). (2) At high altitude, neonates with HIE, pneumonia (<i>p</i> &#x3c; 0.05), anemia, and congenital heart disease (<i>p</i> &#x3c; 0.05) have higher cFTOE than healthy neonates. (3) Compared with HIE neonates from plain areas, neonates with HIE at higher altitude had lower cFTOE (<i>p</i> &#x3c; 0.05), while neonates with heart disease in plateau areas had higher cFTOE than those in plain areas (<i>p</i> &#x3c; 0.05). <b><i>Conclusions:</i></b> The rSO<sub>2</sub> and cFTOE levels in normal neonates from high-altitude areas are lower than neonates from the low-altitude areas. Lower cFTOE is possibly because of an increase in blood flow to the brain, and this may be adversely affected by disease states which may increase the risk of brain injury.

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