Near-Infrared Spectroscopy has been proposed as a useful, non-invasive monitoring technique providing reliable information about cerebral oximetry. Recently, brain damage has been reconsidered as a dynamic process evolving over the weeks of gestation. This thesis investigated NIRS cerebral pattern differences between healthy late preterm infants and very preterm infants becoming late preterm. It was conducted an observational study in 40 late preterm infants, matched for gestational age at monitoring, of whom 20 were born late preterm and 20 were very preterm infants becoming late preterm. Clinical, diagnostic and laboratory monitoring procedures and cerebral oximetry (crSO2) and function (cFTOE index) were recorded on admission into the study. No significant differences (P>0.05, for all) were found between groups regarding clinical, diagnostic or laboratory parameters. Higher crSO2 and lower cFTOE (P<0.001, for both) were found in the late preterm infants group. The obtained results, showing impaired brain oximetry and function in LPT, offer additional support to NIRS parameters as a useful tool for longitudinal monitoring of very preterm infants becoming LPT. Future studies correlating NIRS variables and long-term neurological outcomes in LPT are needed to elucidate the concept of dynamic brain damage pathogenesis.
La Near-Infrared Spectroscopy (NIRS) è stata proposta come tecnica di monitoraggio utile e non invasiva che fornisce informazioni affidabili sull'ossimetria cerebrale. Recentemente, il danno cerebrale è stato riconsiderato come un processo dinamico che si evolve nel corso delle settimane di gestazione. Lo scopo di questa tesi è stato quello di confrontare lo stato di maturazione cerebrale in termini di ossigenazione mediante tecnica NIRS, in neonati late preterm fisiologici e very preterm diventati late preterm. È stato condotto uno studio osservazionale in 40 neonati prematuri, confrontabili per età gestazionale al monitoraggio, di cui 20 sono nati late preterm e 20 very preterm diventati successivamente late preterm. Le procedure di monitoraggio clinico, diagnostico e di laboratorio, l’ ossimetria cerebrale (crSO2) e l’ indice di estrazione frazionale di ossigeno cerebrale (cFTOE) sono state registrate all' ammissione nello studio. Non sono state riscontrate significative differenze statistiche (P > 0,05, per tutti) tra gruppi per quanto riguarda parametri clinici, diagnostici o di laboratorio. Aumentata crSO2 e diminuito cFTOE (P < 0,001, per entrambi) sono stati trovati nel gruppo di neonati late preterm fisologici. I risultati ottenuti, mostrando alterata ossimetria cerebrale nei late preterm, offrono ulteriore supporto ai parametri NIRS come strumento utile per il monitoraggio longitudinale di neonati very preterm che diventano late preterm. Sono necessari studi futuri che correlino le variabili NIRS agli outcomes neurologici a lungo termine nei late preterm, per chiarire il concetto di “patogenesi dinamica di danno cerebrale”.
parametri di monitoraggio cerebrale in neonati late preterm e very preterm diventati late preterm mediante tecnica NIRS
GROMETTO, ALICE
2017/2018
Abstract
Near-Infrared Spectroscopy has been proposed as a useful, non-invasive monitoring technique providing reliable information about cerebral oximetry. Recently, brain damage has been reconsidered as a dynamic process evolving over the weeks of gestation. This thesis investigated NIRS cerebral pattern differences between healthy late preterm infants and very preterm infants becoming late preterm. It was conducted an observational study in 40 late preterm infants, matched for gestational age at monitoring, of whom 20 were born late preterm and 20 were very preterm infants becoming late preterm. Clinical, diagnostic and laboratory monitoring procedures and cerebral oximetry (crSO2) and function (cFTOE index) were recorded on admission into the study. No significant differences (P>0.05, for all) were found between groups regarding clinical, diagnostic or laboratory parameters. Higher crSO2 and lower cFTOE (P<0.001, for both) were found in the late preterm infants group. The obtained results, showing impaired brain oximetry and function in LPT, offer additional support to NIRS parameters as a useful tool for longitudinal monitoring of very preterm infants becoming LPT. Future studies correlating NIRS variables and long-term neurological outcomes in LPT are needed to elucidate the concept of dynamic brain damage pathogenesis.È consentito all'utente scaricare e condividere i documenti disponibili a testo pieno in UNITESI UNIPV nel rispetto della licenza Creative Commons del tipo CC BY NC ND.
Per maggiori informazioni e per verifiche sull'eventuale disponibilità del file scrivere a: unitesi@unipv.it.
https://hdl.handle.net/20.500.14239/21770