Predictive Role of F2-Isoprostanes as Biomarkers for Brain Damage after Neonatal Surgery.

OBJECTIVE: Neonates have a high risk of oxidative stress during anesthetic procedures. The predictive role of oxidative stress biomarkers on the occurrence of brain injury in the perioperative period has not been reported before. METHODS: A prospective cohort study of patients requiring major surgery in the neonatal period was conducted. Biomarker levels of nonprotein-bound iron (NPBI) in plasma and F2-isoprostane in plasma and urine before and after surgical intervention were determined. Brain injury was assessed using postoperative MRI. RESULTS: In total, 61 neonates were included, median gestational age at 39 weeks (range 31-42) and weight at 3000 grams (1400-4400). Mild to moderate brain lesions were found in 66%. Logistic regression analysis showed a significant difference between plasma NPBI in patients with nonparenchymal injury versus no brain injury: 1.34 umol/L was identified as correlation threshold for nonparenchymal injury (sensitivity 67%, specificity 91%). In the multivariable analysis, correcting for GA, no other significant relation was found with the oxidative stress biomarkers and risk factors. CONCLUSION: Oxidative stress seems to occur during anaesthesia in this cohort of neonates. Plasma nonprotein-bound iron showed to be associated with nonparenchymal injury after surgery, with values of 1.34 umol/L or higher. Risk factors should be elucidated in a more homogeneous patient group

Patent Ductus Arteriosus

Patent ductus arteriosus (PDA) is the most common cardiac abnormality of the preterm infant. Its incidence is inversely related to gestational age, such that it affects almost 60% of infants less than 28 weeks’ gestation. Data published in 2007 demonstrated that spontaneous closure of the ductus occurs in 30% of infants with birthweights below 1500 g (very low birth weight [VLBW]) [1]. It is obvious that percentages are decreasing for each lower birthweight category (Table 80.1), but also that a markedly wide variation exists among centers. This may reflect the influence of varying factors on the closure of the ductus.DOI: 10.1007/978-88-470-1405-3_80SCOPUS: ch.binfo:eu-repo/semantics/publishe