Association of early skin breaks and neonatal thalamic maturation: A modifiable risk?
OBJECTIVETo test the hypothesis that a strategy of prolonged arterial line (AL) and central venous line (CVL) use is associated with reduced neonatal invasive procedures and improved growth of the thalamus in extremely preterm born neonates (
Gespeichert in:
| Veröffentlicht in: | Neurology 2020-12, Vol.95 (24), p.e3420-e3427 |
|---|---|
| Hauptverfasser: | , , , , , , , , , , , , |
| Format: | Artikel |
| Sprache: | eng |
| Schlagworte: | |
| Online-Zugang: | Volltext |
| Tags: |
Tag hinzufügen
Keine Tags, Fügen Sie den ersten Tag hinzu!
|
| container_end_page | e3427 |
|---|---|
| container_issue | 24 |
| container_start_page | e3420 |
| container_title | Neurology |
| container_volume | 95 |
| creator | Duerden, Emma G. Grunau, Ruth E. Chau, Vann Groenendaal, Floris Guo, Ting Chakravarty, M. Mallar Benders, Manon Wagenaar, Nienke Eijsermans, Rian Koopman, Corine Synnes, Anne Vries, Linda de Miller, Steven P. |
| description | OBJECTIVETo test the hypothesis that a strategy of prolonged arterial line (AL) and central venous line (CVL) use is associated with reduced neonatal invasive procedures and improved growth of the thalamus in extremely preterm born neonates ( |
| doi_str_mv | 10.1212/WNL.0000000000010953 |
| format | Article |
| fullrecord | <record><control><sourceid>proquest_pubme</sourceid><recordid>TN_cdi_pubmedcentral_primary_oai_pubmedcentral_nih_gov_7836658</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><sourcerecordid>2453691448</sourcerecordid><originalsourceid>FETCH-LOGICAL-c4053-512b97494ad676392a9d0035f23902057e1c75530dc2867cbf92e6a929f358583</originalsourceid><addsrcrecordid>eNqFkUtv1DAUhS0EokPhHyDkJZu0fj9YgEYVUKQRbKhgZ90kDmPGiYudUPXf4-mU8liAN1eyv3Pu9T0IPaXkhDLKTj-935yQX4cSK_k9tKKSqUZx9vk-WhHCTMONNkfoUSlfKySZtg_REefEaGH1Cl2sS0ldgDmkCacBe8jxGpddmHCbPewKhqnHk08TzBDxvIUIY-jwCPOSb1Qv8BqPqQ9DgDZ6nEPZvXqMHgwQi39yW4_RxZvXH8_Om82Ht-_O1pumE0TyRlLW2jqHgF5pxS0D2xPC5cC4JYxI7WmnpeSk75hRumsHy7wCy-zApZGGH6OXB9_LpR193_lpzhDdZQ4j5GuXILg_X6awdV_Sd6cNV-rG4PmtQU7fFl9mN4bS-RihfnkpjgnJlaVC7FFxQLucSsl-uGtDidsn4moi7u9EquzZ7yPeiX5GUAFzAK5SnH0uu7hc-ey2HuK8_Z-3-Id0zylKRcPqLquJJE294ZT_ALJspzQ</addsrcrecordid><sourcetype>Open Access Repository</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>2453691448</pqid></control><display><type>article</type><title>Association of early skin breaks and neonatal thalamic maturation: A modifiable risk?</title><source>MEDLINE</source><source>Journals@Ovid Ovid Autoload</source><source>Alma/SFX Local Collection</source><creator>Duerden, Emma G. ; Grunau, Ruth E. ; Chau, Vann ; Groenendaal, Floris ; Guo, Ting ; Chakravarty, M. Mallar ; Benders, Manon ; Wagenaar, Nienke ; Eijsermans, Rian ; Koopman, Corine ; Synnes, Anne ; Vries, Linda de ; Miller, Steven P.</creator><creatorcontrib>Duerden, Emma G. ; Grunau, Ruth E. ; Chau, Vann ; Groenendaal, Floris ; Guo, Ting ; Chakravarty, M. Mallar ; Benders, Manon ; Wagenaar, Nienke ; Eijsermans, Rian ; Koopman, Corine ; Synnes, Anne ; Vries, Linda de ; Miller, Steven P.</creatorcontrib><description>OBJECTIVETo test the hypothesis that a strategy of prolonged arterial line (AL) and central venous line (CVL) use is associated with reduced neonatal invasive procedures and improved growth of the thalamus in extremely preterm born neonates (<28 weeksʼ gestation).
METHODSTwo international cohorts of very preterm neonates (n = 143) with prolonged (≥14 days) or restricted (<14 days) use of AL/CVL were scanned serially with MRI. General linear models were used to determine the association between skin breaks and thalamic volumes, accounting for clinical confounders and site differences. Children were assessed at preschool age on standardized tests of motor and cognitive function. Outcome scores were assessed in relation to neonatal thalamic growth.
RESULTSProlonged AL/CVL use in neonates (n = 86) was associated with fewer skin breaks (median = 34) during the hospital stay compared to restricted AL/CVL use (n = 57, median = 91, 95% CI = 60.35–84.89). Neonates with prolonged AL/CVL with fewer skin breaks had significantly larger thalamic volumes early in life compared to neonates with restricted line use (B = 121.8, p = 0.001, 95% CI = 48.48–195.11). Neonatal thalamic growth predicted preschool-age cognitive (B = 0.001, 95% CI = 0.0003–0.001, p = 0.002) and motor scores (B = 0.01, 95% CI = 0.001–0.10, p = 0.02). Prolonged AL/CVL use was not associated with greater incidence of sepsis or multiple infections.
CONCLUSIONSProlonged AL/CVL use in preterm neonates may provide an unprecedented opportunity to reduce invasive procedures in preterm neonates. Pain reduction in very preterm neonates is associated with optimal thalamic growth and neurodevelopment.</description><identifier>ISSN: 0028-3878</identifier><identifier>EISSN: 1526-632X</identifier><identifier>DOI: 10.1212/WNL.0000000000010953</identifier><identifier>PMID: 33087497</identifier><language>eng</language><publisher>United States: American Academy of Neurology</publisher><subject>Central Venous Catheters ; Child Development - physiology ; Child, Preschool ; Female ; Humans ; Infant, Extremely Premature - growth & development ; Injections ; Magnetic Resonance Imaging ; Male ; Pain - prevention & control ; Prospective Studies ; Retrospective Studies ; Risk ; Surgical Procedures, Operative ; Thalamus - diagnostic imaging ; Thalamus - growth & development ; Time Factors ; Vascular Access Devices</subject><ispartof>Neurology, 2020-12, Vol.95 (24), p.e3420-e3427</ispartof><rights>American Academy of Neurology</rights><rights>2020 American Academy of Neurology</rights><rights>2020 American Academy of Neurology.</rights><rights>2020 American Academy of Neurology 2020 American Academy of Neurology</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><cites>FETCH-LOGICAL-c4053-512b97494ad676392a9d0035f23902057e1c75530dc2867cbf92e6a929f358583</cites><orcidid>0000-0002-9734-7865</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>230,314,776,780,881,27903,27904</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/33087497$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Duerden, Emma G.</creatorcontrib><creatorcontrib>Grunau, Ruth E.</creatorcontrib><creatorcontrib>Chau, Vann</creatorcontrib><creatorcontrib>Groenendaal, Floris</creatorcontrib><creatorcontrib>Guo, Ting</creatorcontrib><creatorcontrib>Chakravarty, M. Mallar</creatorcontrib><creatorcontrib>Benders, Manon</creatorcontrib><creatorcontrib>Wagenaar, Nienke</creatorcontrib><creatorcontrib>Eijsermans, Rian</creatorcontrib><creatorcontrib>Koopman, Corine</creatorcontrib><creatorcontrib>Synnes, Anne</creatorcontrib><creatorcontrib>Vries, Linda de</creatorcontrib><creatorcontrib>Miller, Steven P.</creatorcontrib><title>Association of early skin breaks and neonatal thalamic maturation: A modifiable risk?</title><title>Neurology</title><addtitle>Neurology</addtitle><description>OBJECTIVETo test the hypothesis that a strategy of prolonged arterial line (AL) and central venous line (CVL) use is associated with reduced neonatal invasive procedures and improved growth of the thalamus in extremely preterm born neonates (<28 weeksʼ gestation).
METHODSTwo international cohorts of very preterm neonates (n = 143) with prolonged (≥14 days) or restricted (<14 days) use of AL/CVL were scanned serially with MRI. General linear models were used to determine the association between skin breaks and thalamic volumes, accounting for clinical confounders and site differences. Children were assessed at preschool age on standardized tests of motor and cognitive function. Outcome scores were assessed in relation to neonatal thalamic growth.
RESULTSProlonged AL/CVL use in neonates (n = 86) was associated with fewer skin breaks (median = 34) during the hospital stay compared to restricted AL/CVL use (n = 57, median = 91, 95% CI = 60.35–84.89). Neonates with prolonged AL/CVL with fewer skin breaks had significantly larger thalamic volumes early in life compared to neonates with restricted line use (B = 121.8, p = 0.001, 95% CI = 48.48–195.11). Neonatal thalamic growth predicted preschool-age cognitive (B = 0.001, 95% CI = 0.0003–0.001, p = 0.002) and motor scores (B = 0.01, 95% CI = 0.001–0.10, p = 0.02). Prolonged AL/CVL use was not associated with greater incidence of sepsis or multiple infections.
CONCLUSIONSProlonged AL/CVL use in preterm neonates may provide an unprecedented opportunity to reduce invasive procedures in preterm neonates. Pain reduction in very preterm neonates is associated with optimal thalamic growth and neurodevelopment.</description><subject>Central Venous Catheters</subject><subject>Child Development - physiology</subject><subject>Child, Preschool</subject><subject>Female</subject><subject>Humans</subject><subject>Infant, Extremely Premature - growth & development</subject><subject>Injections</subject><subject>Magnetic Resonance Imaging</subject><subject>Male</subject><subject>Pain - prevention & control</subject><subject>Prospective Studies</subject><subject>Retrospective Studies</subject><subject>Risk</subject><subject>Surgical Procedures, Operative</subject><subject>Thalamus - diagnostic imaging</subject><subject>Thalamus - growth & development</subject><subject>Time Factors</subject><subject>Vascular Access Devices</subject><issn>0028-3878</issn><issn>1526-632X</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2020</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNqFkUtv1DAUhS0EokPhHyDkJZu0fj9YgEYVUKQRbKhgZ90kDmPGiYudUPXf4-mU8liAN1eyv3Pu9T0IPaXkhDLKTj-935yQX4cSK_k9tKKSqUZx9vk-WhHCTMONNkfoUSlfKySZtg_REefEaGH1Cl2sS0ldgDmkCacBe8jxGpddmHCbPewKhqnHk08TzBDxvIUIY-jwCPOSb1Qv8BqPqQ9DgDZ6nEPZvXqMHgwQi39yW4_RxZvXH8_Om82Ht-_O1pumE0TyRlLW2jqHgF5pxS0D2xPC5cC4JYxI7WmnpeSk75hRumsHy7wCy-zApZGGH6OXB9_LpR193_lpzhDdZQ4j5GuXILg_X6awdV_Sd6cNV-rG4PmtQU7fFl9mN4bS-RihfnkpjgnJlaVC7FFxQLucSsl-uGtDidsn4moi7u9EquzZ7yPeiX5GUAFzAK5SnH0uu7hc-ey2HuK8_Z-3-Id0zylKRcPqLquJJE294ZT_ALJspzQ</recordid><startdate>20201215</startdate><enddate>20201215</enddate><creator>Duerden, Emma G.</creator><creator>Grunau, Ruth E.</creator><creator>Chau, Vann</creator><creator>Groenendaal, Floris</creator><creator>Guo, Ting</creator><creator>Chakravarty, M. Mallar</creator><creator>Benders, Manon</creator><creator>Wagenaar, Nienke</creator><creator>Eijsermans, Rian</creator><creator>Koopman, Corine</creator><creator>Synnes, Anne</creator><creator>Vries, Linda de</creator><creator>Miller, Steven P.</creator><general>American Academy of Neurology</general><general>Lippincott Williams & Wilkins</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope><scope>5PM</scope><orcidid>https://orcid.org/0000-0002-9734-7865</orcidid></search><sort><creationdate>20201215</creationdate><title>Association of early skin breaks and neonatal thalamic maturation: A modifiable risk?</title><author>Duerden, Emma G. ; Grunau, Ruth E. ; Chau, Vann ; Groenendaal, Floris ; Guo, Ting ; Chakravarty, M. Mallar ; Benders, Manon ; Wagenaar, Nienke ; Eijsermans, Rian ; Koopman, Corine ; Synnes, Anne ; Vries, Linda de ; Miller, Steven P.</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c4053-512b97494ad676392a9d0035f23902057e1c75530dc2867cbf92e6a929f358583</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2020</creationdate><topic>Central Venous Catheters</topic><topic>Child Development - physiology</topic><topic>Child, Preschool</topic><topic>Female</topic><topic>Humans</topic><topic>Infant, Extremely Premature - growth & development</topic><topic>Injections</topic><topic>Magnetic Resonance Imaging</topic><topic>Male</topic><topic>Pain - prevention & control</topic><topic>Prospective Studies</topic><topic>Retrospective Studies</topic><topic>Risk</topic><topic>Surgical Procedures, Operative</topic><topic>Thalamus - diagnostic imaging</topic><topic>Thalamus - growth & development</topic><topic>Time Factors</topic><topic>Vascular Access Devices</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Duerden, Emma G.</creatorcontrib><creatorcontrib>Grunau, Ruth E.</creatorcontrib><creatorcontrib>Chau, Vann</creatorcontrib><creatorcontrib>Groenendaal, Floris</creatorcontrib><creatorcontrib>Guo, Ting</creatorcontrib><creatorcontrib>Chakravarty, M. Mallar</creatorcontrib><creatorcontrib>Benders, Manon</creatorcontrib><creatorcontrib>Wagenaar, Nienke</creatorcontrib><creatorcontrib>Eijsermans, Rian</creatorcontrib><creatorcontrib>Koopman, Corine</creatorcontrib><creatorcontrib>Synnes, Anne</creatorcontrib><creatorcontrib>Vries, Linda de</creatorcontrib><creatorcontrib>Miller, Steven P.</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><collection>PubMed Central (Full Participant titles)</collection><jtitle>Neurology</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Duerden, Emma G.</au><au>Grunau, Ruth E.</au><au>Chau, Vann</au><au>Groenendaal, Floris</au><au>Guo, Ting</au><au>Chakravarty, M. Mallar</au><au>Benders, Manon</au><au>Wagenaar, Nienke</au><au>Eijsermans, Rian</au><au>Koopman, Corine</au><au>Synnes, Anne</au><au>Vries, Linda de</au><au>Miller, Steven P.</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Association of early skin breaks and neonatal thalamic maturation: A modifiable risk?</atitle><jtitle>Neurology</jtitle><addtitle>Neurology</addtitle><date>2020-12-15</date><risdate>2020</risdate><volume>95</volume><issue>24</issue><spage>e3420</spage><epage>e3427</epage><pages>e3420-e3427</pages><issn>0028-3878</issn><eissn>1526-632X</eissn><abstract>OBJECTIVETo test the hypothesis that a strategy of prolonged arterial line (AL) and central venous line (CVL) use is associated with reduced neonatal invasive procedures and improved growth of the thalamus in extremely preterm born neonates (<28 weeksʼ gestation).
METHODSTwo international cohorts of very preterm neonates (n = 143) with prolonged (≥14 days) or restricted (<14 days) use of AL/CVL were scanned serially with MRI. General linear models were used to determine the association between skin breaks and thalamic volumes, accounting for clinical confounders and site differences. Children were assessed at preschool age on standardized tests of motor and cognitive function. Outcome scores were assessed in relation to neonatal thalamic growth.
RESULTSProlonged AL/CVL use in neonates (n = 86) was associated with fewer skin breaks (median = 34) during the hospital stay compared to restricted AL/CVL use (n = 57, median = 91, 95% CI = 60.35–84.89). Neonates with prolonged AL/CVL with fewer skin breaks had significantly larger thalamic volumes early in life compared to neonates with restricted line use (B = 121.8, p = 0.001, 95% CI = 48.48–195.11). Neonatal thalamic growth predicted preschool-age cognitive (B = 0.001, 95% CI = 0.0003–0.001, p = 0.002) and motor scores (B = 0.01, 95% CI = 0.001–0.10, p = 0.02). Prolonged AL/CVL use was not associated with greater incidence of sepsis or multiple infections.
CONCLUSIONSProlonged AL/CVL use in preterm neonates may provide an unprecedented opportunity to reduce invasive procedures in preterm neonates. Pain reduction in very preterm neonates is associated with optimal thalamic growth and neurodevelopment.</abstract><cop>United States</cop><pub>American Academy of Neurology</pub><pmid>33087497</pmid><doi>10.1212/WNL.0000000000010953</doi><orcidid>https://orcid.org/0000-0002-9734-7865</orcidid><oa>free_for_read</oa></addata></record> |
| fulltext | fulltext |
| identifier | ISSN: 0028-3878 |
| ispartof | Neurology, 2020-12, Vol.95 (24), p.e3420-e3427 |
| issn | 0028-3878 1526-632X |
| language | eng |
| recordid | cdi_pubmedcentral_primary_oai_pubmedcentral_nih_gov_7836658 |
| source | MEDLINE; Journals@Ovid Ovid Autoload; Alma/SFX Local Collection |
| subjects | Central Venous Catheters Child Development - physiology Child, Preschool Female Humans Infant, Extremely Premature - growth & development Injections Magnetic Resonance Imaging Male Pain - prevention & control Prospective Studies Retrospective Studies Risk Surgical Procedures, Operative Thalamus - diagnostic imaging Thalamus - growth & development Time Factors Vascular Access Devices |
| title | Association of early skin breaks and neonatal thalamic maturation: A modifiable risk? |
| url | https://sfx.bib-bvb.de/sfx_tum?ctx_ver=Z39.88-2004&ctx_enc=info:ofi/enc:UTF-8&ctx_tim=2025-01-25T13%3A42%3A42IST&url_ver=Z39.88-2004&url_ctx_fmt=infofi/fmt:kev:mtx:ctx&rfr_id=info:sid/primo.exlibrisgroup.com:primo3-Article-proquest_pubme&rft_val_fmt=info:ofi/fmt:kev:mtx:journal&rft.genre=article&rft.atitle=Association%20of%20early%20skin%20breaks%20and%20neonatal%20thalamic%20maturation:%20A%20modifiable%20risk?&rft.jtitle=Neurology&rft.au=Duerden,%20Emma%20G.&rft.date=2020-12-15&rft.volume=95&rft.issue=24&rft.spage=e3420&rft.epage=e3427&rft.pages=e3420-e3427&rft.issn=0028-3878&rft.eissn=1526-632X&rft_id=info:doi/10.1212/WNL.0000000000010953&rft_dat=%3Cproquest_pubme%3E2453691448%3C/proquest_pubme%3E%3Curl%3E%3C/url%3E&disable_directlink=true&sfx.directlink=off&sfx.report_link=0&rft_id=info:oai/&rft_pqid=2453691448&rft_id=info:pmid/33087497&rfr_iscdi=true |