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Evaluating a Targeted Bedside Measure of Cerebral Perfusion in a Nonhuman Primate Model of Neonatal Hypoxic‐Ischemic Encephalopathy
Author(s) -
Peeples Eric S.,
Ezeokeke Chikodinaka K.,
Juul Sandra E.,
Mourad Pierre D.
Publication year - 2018
Publication title -
journal of ultrasound in medicine
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.574
H-Index - 91
eISSN - 1550-9613
pISSN - 0278-4297
DOI - 10.1002/jum.14426
Subject(s) - medicine , hypoxic ischemic encephalopathy , primate , nonhuman primate , encephalopathy , perfusion , neonatal encephalopathy , cerebral perfusion pressure , neuroscience , pathology , cardiology , evolutionary biology , biology
Objectives To compare ultrasound‐derived resistive indices (RIs) obtained at the level of the thalamus via fast Doppler ultrasound with traditional anterior cerebral artery measures in a model of neonatal hypoxic‐ischemic encephalopathy and to correlate each with clinical outcomes. Methods Nine nonhuman primate neonates underwent no umbilical cord occlusion (n = 3), umbilical cord occlusion without hypothermia (n = 3), or umbilical cord occlusion with hypothermia (n = 3). The RI was measured in the anterior cerebral artery and thalamus on days 0, 1, and 4 of life. Magnetic resonance imaging with spectroscopy was performed on day 4. Results Mean thalamus and anterior cerebral artery RI values in the first 36 hours of life were statistically different in neonates who died (+0.13; P = .019) or developed cerebral palsy (−0.08; P = .003). Thalamic RI values showed stronger associations with serum and spectroscopic lactate values than those in the anterior cerebral artery. The umbilical cord occlusion‐with‐hypothermia group showed a significant increase in the RI in the thalamus but not the anterior cerebral artery. Conclusions Resistive index measurements in the thalamus may eventually supplement other bedside measures for predicting outcomes in the HIE population, but further studies need to differentiate the effect of hypothermia from illness severity on thalamic perfusion.