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Klin Padiatr 2015; 227(05): 264-268
DOI: 10.1055/s-0035-1547309
Original Article
© Georg Thieme Verlag KG Stuttgart · New York

Electrocortical Activity at 7 Days of Life is Affected in Extremely Premature Infants with Patent Ductus Arteriosus

Die elektrokortikale Aktivität extrem unreifer Frühgeborener im Alter von 7 Tagen mit PDA ist beeinträchtigt
N. Bruns
1   Department of Pediatrics I, University Hospital Essen, Essen, Germany
,
B. Metze
2   Neonatology, Charité University Hospital Berlin, Berlin, Germany
,
C. Bührer
2   Neonatology, Charité University Hospital Berlin, Berlin, Germany
,
U. Felderhoff-Müser
1   Department of Pediatrics I, University Hospital Essen, Essen, Germany
,
D. Hüseman
3   Department of Pediatrics, Hospital Barnim, Eberswalde, Germany
› Author Affiliations
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Publication History

Publication Date:
14 April 2015 (online)

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Abstract

Background: The aim of this study was to determine whether the aEEG at 7 days of life is influenced by the presence of a PDA in non-sedated extremely low gestational age preterm infants.

Patients: We prospectively recruited infants born at less than 28 weeks of gestation between 11/2007 and 12/2009.

Method: aEEGs were recorded at seven days of life and assessed by using the Burdjalov score and the electronically assessed lower border (eLBA). Kruskal-Wallis-Test and linear regression analysis were performed to determine how GA and a PDA affect the aEEG score and the eLBA. Using linear regression analysis we tested which components of the score are affected by a PDA.

Results: We recruited 44 infants with a GA of 26.5/7 (23.4/7–27.6/7) weeks and a birth weight of 837 (461–1230) g. The total sum of score points increased from 4 (1–6) to 8 (5–9) points in infants born at 23/24 weeks and 27 weeks of gestation, respectively. In infants with relevant PDA the aEEG scored lower with 8 (3–10) points compared to those with PDA: 5 (1–8) points. Linear regression analysis showed a positive influence of GA and a negative influence of a PDA on the total score. GA had a positive influence on SWC and the visually assessed LBA. A PDA had a negative influence on continuity. The eLBA increased from 4.61 (3.18–5.53) µV to 5.27 (3.38–6.51) µV in infants of 23/24 vs. 27 gestational weeks, but was not significantly influenced by a PDA.

Conclusion: A PDA has a negative influence on the total Burdjalov score and continuity at 7 days of age in infants born at less than 28 weeks of gestation. The electrocortical disturbances may be the consequence of a diminished cerebral perfusion in the presence of a PDA.

Zusammenfassung

Hintergrund: Ziel der Studie war zu untersuchen, ob das aEEG bei stabilen nicht-sedierten extrem unreifen Frühgeborenen am 7. LT durch einen PDA beeinflusst wird.

Patienten: Prospektiver Einschluss von Frühgeborenen mit einem GA<28 SSW.

Methode: Am 7. LT wurden aEEGs aufgezeichnet. Die Bewertung erfolgte durch den Burdjalov score sowie durch die elektronisch ermittelte untere Amplitude (eLBA). Mittels Kruskal-Wallis-Test und linearer Regressionsanalyse ermittelten wir, wie das GA und ein PDA den Score und die eLBA beeinflussen. Nun überprüften wir mittels linearer Regressionsanalyse, welche Komponenten des Burdjalov score durch einen PDA beeinflusst werden.

Ergebnisse: 44 Frühgeborene mit einem medianen GA von 26,5/7 (23,4/7–27,6/7), medianes Geburtsgewicht 837 (461–1 230) g wurden untersucht. Der Gesamtscore stieg von 4 (1–6) Punkten bei 23/24 SSW auf 8 (5–9) Punkte bei 27 SSW an. Kinder mit einem relevanten PDA hatten eine reduzierte Punktzahl von 5 (1–8) im Vergleich zu 8 (3–10) Punkten bei Kindern ohne PDA. Die lineare Regressionsanalyse zeigte einen Anstieg des Scores mit dem GA und eine Reduktion der Punktzahl durch einen PDA. Das GA hat einen positiven Einfluss auf den Schlaf-Wach-Rhythmus und die untere Amplitude, ein PDA hat einen negativen Einfluss auf die Kontinuität. Die eLBA stieg von 4,61 (3,18–5,53) µV bei 23/24 SSW auf 5,27 (3,38–6,51) µV bei 27 SSW ohne signifikante Beeinflussung durch einen PDA.

Schlussfolgerung: Ein persistierender Ductus arteriosus reduziert die Gesamtpunktzahl und die Kontinuität im Burdjalov score bei extrem unreifen Frühgeborenen im Alter von 7 Tagen. Diese elektrokorticalen Veränderungen könnten die Folge einer PDA-bedingten reduzierten zerebralen Perfusion darstellen.

Key words

preterm - PDA - aEEG - brain maturation

Schlüsselwörter

Frühgeborene - PDA - aEEG - Hirnreifung

 

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