Observational studyPediatric research2022
Clinical determinants of cerebrovascular reactivity in very preterm infants during the transitional period.
Observational study in Pediatric research, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 13 papers, 2 of them syntheses that pooled it.
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Who cites it
13 citing papers in PubMed, 2 syntheses or guidelines pooled it, 13 citations in OpenAlex.
- Cerebrovascular autoregulation and preterm brain injury: a systematic review and meta-analysis.Pediatric research · 2025Pooled it
- Occurrence and Time of Onset of Intraventricular Hemorrhage in Preterm Neonates: A Systematic Review and Meta-Analysis of Individual Patient Data.JAMA pediatrics · 2025Pooled it
- Intraventricular hemorrhage in extremely low birth weight infants: frequency and duration of impaired cerebrovascular reactivity.Pediatric research · 2026Article
- Epigenetic modifications of VEGF, cerebral hypoxia, and impaired cerebrovascular autoregulation as early indicators for preterm brain injury.Function (Oxford, England) · 2026Observational
- Hemodynamic Changes in the Transition Period in the Preterm and Term Infant: Basic Concepts.Turkish archives of pediatrics · 2025Article
- Cerebral autoregulation in pediatric and neonatal intensive care: A scoping review.Journal of cerebral blood flow and metabolism : official journal of the International Society of Cerebral Blood Flow and Metabolism · 2024Article
- Cardiovascular and cerebrovascular effects of caffeine maintenance in preterm infants during the transitional period.Pediatric research · 2024Observational
- Near-infrared spectroscopy monitoring of neonatal cerebrovascular reactivity: where are we now?Pediatric research · 2024Review
- Cerebrovascular Autoregulation in Preterm Infants Using Heart Rate or Blood Pressure: A Pilot Study.Children (Basel, Switzerland) · 2024Article
- Comparison of Near-Infrared Spectroscopy-Based Cerebral Autoregulatory Indices in Extremely Low Birth Weight Infants.Children (Basel, Switzerland) · 2023Article
- Machine Learning Detects Intraventricular Haemorrhage in Extremely Preterm Infants.Children (Basel, Switzerland) · 2023Article
- Pathogenesis and Prevention of Intraventricular Hemorrhage in Preterm Infants.Journal of Korean Neurosurgical Society · 2023Article
- Transcranial ultrasound diagnostic value of hemodynamic cerebral changes in preterm infants for early-onset sepsis.Translational pediatrics · 2022Article
Corrections and comments
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Authors and funding
10 authors at 5 institutions in 2 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundPreterm infants are at enhanced risk of brain injury due to altered cerebral haemodynamics during postnatal transition. This observational study aimed to assess the clinical determinants of transitional cerebrovascular reactivity and its association with intraventricular haemorrhage (IVH).
methodsPreterm infants <32 weeks underwent continuous monitoring of cerebral oxygenation and heart rate over the first 72 h after birth. Serial cranial and cardiac ultrasound assessments were performed to evaluate the ductal status and to diagnose IVH onset. The moving correlation coefficient between cerebral oxygenation and heart rate (TOHRx) was calculated. Linear mixed-effect models were used to analyse the impact of relevant clinical variables on TOHRx. The association between TOHRx and IVH development was also assessed.
resultsSeventy-seven infants were included. A haemodynamically significant patent ductus arteriosus (hsPDA) (β = 0.044, 95% CI: 0.007-0.081) and ongoing dopamine treatment (β = 0.096, 95% CI: 0.032-0.159) were associated with increasing TOHRx, indicating impaired cerebrovascular reactivity. A significant association between TOHRx, mean arterial blood pressure (β = -0.004, 95% CI: -0.007, -0.001) and CRIB-II score (β = 0.007, 95% CI: 0.001-0.015) was also observed. TOHRx was significantly higher in infants developing high-grade IVH compared to those without IVH.
conclusionsDopamine treatment, low blood pressure, hsPDA and high CRIB-II are associated with impaired cerebrovascular reactivity during postnatal transition, with potential implications on IVH development. IMPACT: The correlation coefficient between cerebral oxygenation and heart rate (TOHRx) provides a non-invasive estimation of cerebrovascular reactivity, whose failure has a potential pathogenic role in the development of IVH in preterm infants. This study shows that cerebrovascular reactivity during the transitional period improves over time and is affected by specific clinical and therapeutic factors, whose knowledge could support the development of individualized neuroprotective strategies in at-risk preterm infants. The evidence of increased TOHRx in infants developing high-grade compared to low-grade or no IVH during the transitional period further supports the role of impaired cerebrovascular reactivity in IVH pathophysiology.
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