Steven Miller: When Injury Happens: Imaging the Newborn Brain ...
Steven Miller: When Injury Happens: Imaging the Newborn Brain ...
Steven Miller: When Injury Happens: Imaging the Newborn Brain ...
Create successful ePaper yourself
Turn your PDF publications into a flip-book with our unique Google optimized e-Paper software.
Pre-operative <strong>Injury</strong><br />
Median (Range) or No <strong>Brain</strong> <strong>Injury</strong> Acquired P<br />
Number (%)<br />
<strong>Brain</strong> <strong>Injury</strong><br />
Number of patients 17 (59%) 12 (41%)<br />
Balloon Atrial 7 (41%) 12 (100%) 0.001<br />
Septostomy<br />
SNAP-PE 14 (9 - 26) 19.5 (9 - 30) 0.1<br />
Lowest O 2 saturation<br />
recorded<br />
70 (26 - 82) 50 (20 - 70) 0.05<br />
Term<br />
Birth<br />
PreOp<br />
MRI<br />
Bypass<br />
PostOp<br />
MRI<br />
Outcome<br />
McQuillen PS et al. Stroke 2007<br />
Perioperative white matter injury is common<br />
WMI Stroke Any<br />
Preoperative<br />
N=62<br />
11 (18%)<br />
13 (21%)<br />
23 (37%)<br />
Postoperative<br />
N=53<br />
Totals<br />
14 (26%)<br />
23 (40%)<br />
5 (9%)<br />
15 (26%)<br />
19 (36%)<br />
32 (56%)<br />
Impaired Global Oxygen Delivery<br />
Median (Range) or Number (%) No Postop New Postop P<br />
<strong>Injury</strong><br />
<strong>Injury</strong><br />
Number of patients 34 19<br />
Preoperative brain injury 13 (38%) 7 (37%) 0.6<br />
Lowest flow ml/kg/min 142 (22 - 229) 85 (17 - 197) 0.05<br />
Bypass Full Flow 26 (76%) 8 (42%)<br />
strategy RCP 2 (6%) 8 (42%)<br />
O<strong>the</strong>r 6 (18%) 3 (16%) 0.01<br />
Postop Day #1 Lowest<br />
MBP<br />
45 (33 - 66) 41 (33 - 63) 0.09<br />
<strong>When</strong> brain injury happens in<br />
newborns with heart disease<br />
• Pre-operative stroke<br />
– Therapeutic ca<strong>the</strong>terization procedures<br />
• Post-operative white matter injury<br />
– Bypass strategy<br />
– Low cardiac output state<br />
• Different modifiable risk factors<br />
3
Change language