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Pfurtscheller, D; Baik-Schneditz, N; Schwaberger, B; Urlesberger, B; Pichler, G.
Insights into Neonatal Cerebral Autoregulation by Blood Pressure Monitoring and Cerebral Tissue Oxygenation: A Qualitative Systematic Review.
Children (Basel). 2023; 10(8): Doi: 10.3390/children10081304 [OPEN ACCESS]
Web of Science PubMed PUBMED Central FullText FullText_MUG

 

Leading authors Med Uni Graz
Pfurtscheller Daniel
Pichler Gerhard
Co-authors Med Uni Graz
Baik-Schneditz Nariae
Schwaberger Bernhard
Urlesberger Berndt
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Abstract:
OBJECTIVE: The aim of this qualitative systematic review was to identify publications on blood pressure monitoring in combination with cerebral tissue oxygenation monitoring during the first week after birth focusing on cerebral autoregulation. METHODS: A systematic search was performed on PubMed. The following search terms were used: infants/newborn/neonates, blood pressure/systolic/diastolic/mean/MAP/SAP/DAP, near-infrared spectroscopy, oxygenation/saturation/oxygen, and brain/cerebral. Additional studies were identified by a manual search of references in the retrieved studies and reviews. Only human studies were included. RESULTS: Thirty-one studies focused on preterm neonates, while five included preterm and term neonates. In stable term neonates, intact cerebral autoregulation was shown by combining cerebral tissue oxygenation and blood pressure during immediate transition, while impaired autoregulation was observed in preterm neonates with respiratory support. Within the first 24 h, stable preterm neonates had reduced cerebral tissue oxygenation with intact cerebral autoregulation, while sick neonates showed a higher prevalence of impaired autoregulation. Further cardio-circulatory treatment had a limited effect on cerebral autoregulation. Impaired autoregulation, with dependency on blood pressure and cerebral tissue oxygenation, increased the risk of intraventricular hemorrhage and abnormal neurodevelopmental outcomes. CONCLUSIONS: Integrating blood pressure monitoring with cerebral tissue oxygenation measurements has the potential to improve treatment decisions and optimizes neurodevelopmental outcomes in high-risk neonates.

Find related publications in this database (Keywords)
neonate
blood pressure
NIRS
cerebral oxygenation
cerebral autoregulation
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