Mechanical Ventilation Duration, Brainstem Development, and Neurodevelopment in Children Born Preterm: A Prospective Cohort Study.

Details

Serval ID
serval:BIB_27754F81E991
Type
Article: article from journal or magazin.
Collection
Publications
Institution
Title
Mechanical Ventilation Duration, Brainstem Development, and Neurodevelopment in Children Born Preterm: A Prospective Cohort Study.
Journal
The Journal of pediatrics
Author(s)
Guillot M., Guo T., Ufkes S., Schneider J., Synnes A., Chau V., Grunau R.E., Miller S.P.
ISSN
1097-6833 (Electronic)
ISSN-L
0022-3476
Publication state
Published
Issued date
11/2020
Peer-reviewed
Oui
Volume
226
Pages
87-95.e3
Language
english
Notes
Publication types: Journal Article ; Research Support, Non-U.S. Gov't
Publication Status: ppublish
Abstract
To determine, in children born preterm, the association of mechanical ventilation duration with brainstem development, white matter maturation, and neurodevelopmental outcomes at preschool age.
This prospective cohort study included 144 neonates born at <30 weeks of gestation (75 male, mean gestational age 27.1 weeks, SD 1.6) with regional brainstem volumes automatically segmented on magnetic resonance imaging at term-equivalent age (TEA). The white matter maturation was assessed by diffusion tensor imaging and tract-based spatial statistics. Neurodevelopmental outcomes were assessed at 4.5 years of age using the Movement Assessment Battery for Children, 2nd Edition, and the Wechsler Primary and Preschool Scale of Intelligence, 4th Edition, full-scale IQ. The association between the duration of mechanical ventilation and brainstem development was validated in an independent cohort of children born very preterm.
Each additional day of mechanical ventilation predicted lower motor scores (0.5-point decrease in the Movement Assessment Battery for Children, 2nd Edition, score by day of mechanical ventilation, 95% CI -0.6 to -0.3, P < .0001). Prolonged exposure to mechanical ventilation was associated with smaller pons and medulla volumes at TEA in 2 independent cohorts, along with widespread abnormalities in white matter maturation. Pons and medulla volumes at TEA predicted motor outcomes at 4.5 years of age.
In neonates born very preterm, prolonged mechanical ventilation is associated with impaired brainstem development, abnormal white matter maturation, and lower motor scores at preschool age. Further research is needed to better understand the neural pathological mechanisms involved.
Keywords
Brain Stem/growth & development, Child Development/physiology, Child, Preschool, Cohort Studies, Diffusion Tensor Imaging, Female, Humans, Infant, Infant, Newborn, Infant, Premature, Infant, Premature, Diseases/diagnostic imaging, Infant, Premature, Diseases/physiopathology, Infant, Premature, Diseases/therapy, Magnetic Resonance Imaging, Male, Motor Activity/physiology, Neurodevelopmental Disorders/epidemiology, Organ Size, Prospective Studies, Respiration, Artificial/adverse effects, Time Factors, White Matter/growth & development, bronchopulmonary dysplasia, motor development, newborn, white matter
Pubmed
Web of science
Create date
10/06/2020 21:38
Last modification date
21/01/2022 6:35
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