Investigation the Factors of Brain Injury in Children with Patent Ductus Arteriosus Based on Ultrasound Cerebral Blood Flow Parameters

doi:10.7517/issn.1674-0475.230607

Abstract

Abstract: This article explores the factors leading to brain injury in children with patent ductus arteriosus (PDA) based on ultrasound cerebral blood flow parameters. 207 premature infants with PDA were divided into a non brain injury group (148 cases) and a brain injury group (59 cases) as the study subjects. Compare the clinical data and cerebral blood flow parameters of two groups of research subjects, and analyze the risk factors that may cause brain injury. The efficacy of combining clinical indicators and cerebral blood flow parameters in predicting the occurrence of brain injury. Build a column chart model and validate it. The results showed that birth weight, chorioamnionitis, 5-minute Apgar score, middle cerebral artery resistance index (RI), and anterior cerebral artery RI were all influencing factors for the occurrence of brain injury in premature infants with PDA (OR>1, P<0.05). The column chart prediction model has good discrimination, accuracy, and effectiveness. The combination of cerebral blood flow parameters and clinical indicators has higher diagnostic efficacy in predicting brain injury.

Key words: doppler, patent ductus arteriosus, cerebral blood flow parameters, brain injury

LV Xia, DUAN Yanni, ZHANG Mengmeng, MA Liqiong. Investigation the Factors of Brain Injury in Children with Patent Ductus Arteriosus Based on Ultrasound Cerebral Blood Flow Parameters[J]. IMAGING SCIENCE AND PHOTOCHEMISTRY, 2023, 41(6): 300-306.

References

[1] Mitra S, McNamara P J. Patent ductus arteriosus-Time for a definitive trial[J]. Clinics in Perinatology, 2020, 47(3):617-639.
[2] Miller L E, Stoller J Z, Fraga M V. Point-of-care ultrasound in the neonatal ICU[J]. Current Opinion in Pediatrics, 2020, 32(2):216-227.
[3] Ophelders D R M G, Gussenhoven R, Klein L, et al. Preterm brain injury, antenatal triggers, and therapeutics:Timing is key[J]. Cells, 2020, 9(8):1871.
[4] Shao R J, Sun D W, Hu Y, et al. White matter injury in the neonatal hypoxic-ischemic brain and potential therapies targeting microglia[J]. Journal of Neuroscience Research, 2021, 99(4):991-1008.
[5] 中国医师协会新生儿专业委员会. 早产儿脑损伤诊断与防治专家共识[J]. 中国当代儿科杂志, 2012, 14(12):883-884.
[6] Ruoss J L, Bazacliu C, Giesinger R E, et al. Patent ductus arteriosus and cerebral, cardiac, and gut hemodynamics in premature neonates[J]. Seminars in Fetal and Neonatal Medicine, 2020, 25(5):101120.
[7] Su B H, Lin H Y, Chiu H Y, et al. Therapeutic strategy of patent ductus arteriosus in extremely preterm infants[J]. Pediatrics & Neonatology, 2020, 61(2):133-141.
[8] Mitra S, Weisz D, Jain A, et al. Management of the patent ductus arteriosus in preterm infants[J]. Paediatrics & Child Health, 2022, 27(1):63-64.
[9] Shin S H, Sohn J A, Kim E K, et al. Factors associated with the follow-up of high risk infants discharged from a neonatal intensive care unit[J]. Pediatrics & Neonatology, 2022, 63(4):373-379.
[10] Prasad J D, Gunn K C, Davidson J O, et al. Anti-inflammatory therapies for treatment of inflammation-related preterm brain injury[J]. International Journal of Molecular Sciences, 2021, 22(8):4008.
[11] Lee E S, Kim E K, Shin S H, et al. Factors associated with neurodevelopment in preterm infants with systematic inflammation[J]. BMC Pediatrics, 2021, 21(1):114-125.
[12] Chen H R, Chen C W, Kuo Y M, et al. Monocytes promote acute neuroinflammation and become pathological microglia in neonatal hypoxic-ischemic brain injury[J]. Theranostics, 2022, 12(2):512-529.
[13] Morton S, Kua J, Mullington C J. Epidural analgesia, intrapartum hyperthermia, and neonatal brain injury:A systematic review and meta-analysis[J]. British Journal of Anaesthesia, 2021, 126(2):500-515.
[14] Shi Z J, Luo K H, Deol S, et al. A systematic review of noninflammatory cerebrospinal fluid biomarkers for clinical outcome in neonates with perinatal hypoxic brain injury that could be biologically significant[J]. Journal of Neuroscience Research, 2022, 100(12):2154-2173.
[15] Fogarty M, Osborn D A, Askie L, et al. Delayed vs early umbilical cord clamping for preterm infants:A systematic review and meta-analysis[J]. American Journal of Obstetrics and Gynecology, 2018, 218(1):1-18.
[16] Kooi E M W, Richter A E. Cerebral autoregulation in sick infants:Current insights[J]. Clinics in Perinatology, 2020, 47(3):449-467.
[17] Camfferman F A, de Goederen R, Govaert P, et al. Diagnostic and predictive value of Doppler ultrasound for evaluation of the brain circulation in preterm infants:A systematic review[J]. Pediatric Research, 2020, 87(Suppl 1):50-58.
[18] Bravo M C, Cabañas F, Riera J, et al. Randomised controlled clinical trial of standard versus echocardiographically guided ibuprofen treatment for patent ductus arteriosus in preterm infants:A pilot study[J]. The Journal of Maternal-Fetal & Neonatal Medicine, 2014, 27(9):904-909.