Cerebral oxygen saturation and cerebrovascular instability in newborn infants with congenital heart disease compared to healthy controls.

<h4>Objective</h4>Infants with Congenital Heart Disease (CHD) are at risk for developmental delays, though the mechanisms of brain injury that impair development are unknown. Potential causes could include cerebral hypoxia and cerebrovascular instability. We hypothesized that we would de...

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Autores principales: Nhu N Tran, Jodie K Votava-Smith, John C Wood, Ashok Panigrahy, Choo Phei Wee, Matthew Borzage, S Ram Kumar, Paula M Murray, Mary-Lynn Brecht, Lisa Paquette, Kenneth M Brady, Bradley S Peterson
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spelling oai:doaj.org-article:b67037f93ab44a37a69dd9fdbb866bbe2021-12-02T20:11:24ZCerebral oxygen saturation and cerebrovascular instability in newborn infants with congenital heart disease compared to healthy controls.1932-620310.1371/journal.pone.0251255https://doaj.org/article/b67037f93ab44a37a69dd9fdbb866bbe2021-01-01T00:00:00Zhttps://doi.org/10.1371/journal.pone.0251255https://doaj.org/toc/1932-6203<h4>Objective</h4>Infants with Congenital Heart Disease (CHD) are at risk for developmental delays, though the mechanisms of brain injury that impair development are unknown. Potential causes could include cerebral hypoxia and cerebrovascular instability. We hypothesized that we would detect significantly reduced cerebral oxygen saturation and greater cerebrovascular instability in CHD infants compared to the healthy controls.<h4>Methods</h4>We performed a secondary analysis on a sample of 43 term infants (28 CHD, 15 healthy controls) that assessed prospectively in temporal cross-section before or at 12 days of age. CHD infants were assessed prior to open-heart surgery. Cerebral oxygen saturation levels were estimated using Near-Infrared Spectroscopy, and cerebrovascular stability was assessed with the response of cerebral oxygen saturation after a postural change (supine to sitting).<h4>Results</h4>Cerebral oxygen saturation was 9 points lower in CHD than control infants in both postures (β = -9.3; 95%CI = -17.68, -1.00; p = 0.028), even after controlling for differences in peripheral oxygen saturation. Cerebrovascular stability was significantly impaired in CHD compared to healthy infants (β = -2.4; 95%CI = -4.12, -.61; p = 0.008), and in CHD infants with single ventricle compared with biventricular defects (β = -1.5; 95%CI = -2.95, -0.05; p = 0.04).<h4>Conclusion</h4>CHD infants had cerebral hypoxia and decreased cerebral oxygen saturation values following a postural change, suggesting cerebrovascular instability. Future longitudinal studies should assess the associations of cerebral hypoxia and cerebrovascular instability with long-term neurodevelopmental outcomes in CHD infants.Nhu N TranJodie K Votava-SmithJohn C WoodAshok PanigrahyChoo Phei WeeMatthew BorzageS Ram KumarPaula M MurrayMary-Lynn BrechtLisa PaquetteKenneth M BradyBradley S PetersonPublic Library of Science (PLoS)articleMedicineRScienceQENPLoS ONE, Vol 16, Iss 5, p e0251255 (2021)
institution DOAJ
collection DOAJ
language EN
topic Medicine
R
Science
Q
spellingShingle Medicine
R
Science
Q
Nhu N Tran
Jodie K Votava-Smith
John C Wood
Ashok Panigrahy
Choo Phei Wee
Matthew Borzage
S Ram Kumar
Paula M Murray
Mary-Lynn Brecht
Lisa Paquette
Kenneth M Brady
Bradley S Peterson
Cerebral oxygen saturation and cerebrovascular instability in newborn infants with congenital heart disease compared to healthy controls.
description <h4>Objective</h4>Infants with Congenital Heart Disease (CHD) are at risk for developmental delays, though the mechanisms of brain injury that impair development are unknown. Potential causes could include cerebral hypoxia and cerebrovascular instability. We hypothesized that we would detect significantly reduced cerebral oxygen saturation and greater cerebrovascular instability in CHD infants compared to the healthy controls.<h4>Methods</h4>We performed a secondary analysis on a sample of 43 term infants (28 CHD, 15 healthy controls) that assessed prospectively in temporal cross-section before or at 12 days of age. CHD infants were assessed prior to open-heart surgery. Cerebral oxygen saturation levels were estimated using Near-Infrared Spectroscopy, and cerebrovascular stability was assessed with the response of cerebral oxygen saturation after a postural change (supine to sitting).<h4>Results</h4>Cerebral oxygen saturation was 9 points lower in CHD than control infants in both postures (β = -9.3; 95%CI = -17.68, -1.00; p = 0.028), even after controlling for differences in peripheral oxygen saturation. Cerebrovascular stability was significantly impaired in CHD compared to healthy infants (β = -2.4; 95%CI = -4.12, -.61; p = 0.008), and in CHD infants with single ventricle compared with biventricular defects (β = -1.5; 95%CI = -2.95, -0.05; p = 0.04).<h4>Conclusion</h4>CHD infants had cerebral hypoxia and decreased cerebral oxygen saturation values following a postural change, suggesting cerebrovascular instability. Future longitudinal studies should assess the associations of cerebral hypoxia and cerebrovascular instability with long-term neurodevelopmental outcomes in CHD infants.
format article
author Nhu N Tran
Jodie K Votava-Smith
John C Wood
Ashok Panigrahy
Choo Phei Wee
Matthew Borzage
S Ram Kumar
Paula M Murray
Mary-Lynn Brecht
Lisa Paquette
Kenneth M Brady
Bradley S Peterson
author_facet Nhu N Tran
Jodie K Votava-Smith
John C Wood
Ashok Panigrahy
Choo Phei Wee
Matthew Borzage
S Ram Kumar
Paula M Murray
Mary-Lynn Brecht
Lisa Paquette
Kenneth M Brady
Bradley S Peterson
author_sort Nhu N Tran
title Cerebral oxygen saturation and cerebrovascular instability in newborn infants with congenital heart disease compared to healthy controls.
title_short Cerebral oxygen saturation and cerebrovascular instability in newborn infants with congenital heart disease compared to healthy controls.
title_full Cerebral oxygen saturation and cerebrovascular instability in newborn infants with congenital heart disease compared to healthy controls.
title_fullStr Cerebral oxygen saturation and cerebrovascular instability in newborn infants with congenital heart disease compared to healthy controls.
title_full_unstemmed Cerebral oxygen saturation and cerebrovascular instability in newborn infants with congenital heart disease compared to healthy controls.
title_sort cerebral oxygen saturation and cerebrovascular instability in newborn infants with congenital heart disease compared to healthy controls.
publisher Public Library of Science (PLoS)
publishDate 2021
url https://doaj.org/article/b67037f93ab44a37a69dd9fdbb866bbe
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