Introduction Very and extremely preterm infants frequently have brain injury-related long-term neurodevelopmental problems. Altered perfusion, for example, seen in the context of a hemodynamically significant patent ductus arteriosus (PDA), has been linked to injury of the immature brain. However, a direct relation with outcome has not been reviewed systematically. Methods A systematic review was conducted to provide an overview of the value of different cerebral arterial blood flow parameters assessed by Doppler ultrasound, in relation to brain injury, to predict long-term neurodevelopmental outcome in preterm infants. Results In total, 23 studies were included. Because of heterogeneity of studies, a meta-analysis of results was not possible. All included studies on resistance index (RI) showed significantly higher values in subjects with a hemodynamically significant PDA. However, absolute differences in RI values were small. Studies using Doppler parameters to predict brain injury and long-term neurodevelopmental outcome were inconsistent. Discussion There is no clear evidence to support the routine determination of RI or other Doppler parameters in the cerebral arteries to predict brain injury and long-term neurodevelopmental outcome in the preterm infant. However, there is evidence that elevated RI can point to the presence of a hemodynamically significant PDA.

中文翻译：

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多普勒超声对早产儿脑循环评估的诊断和预测价值：系统评价

简介 极早产儿和极早产儿经常有脑损伤相关的长期神经发育问题。例如，在血流动力学显着的动脉导管未闭 (PDA) 的背景下看到的灌注改变与未成熟大脑的损伤有关。然而，尚未系统地审查与结果的直接关系。方法进行了系统评价，以概述多普勒超声评估的不同脑动脉血流参数与脑损伤相关的价值，以预测早产儿的长期神经发育结果。结果共纳入23项研究。由于研究的异质性，结果的荟萃分析是不可能的。所有纳入的关于阻力指数 (RI) 的研究显示，在具有显着血流动力学意义的 PDA 的受试者中，该值显着更高。然而，RI 值的绝对差异很小。使用多普勒参数预测脑损伤和长期神经发育结果的研究不一致。讨论 没有明确的证据支持常规测定脑动脉中的 RI 或其他多普勒参数以预测早产儿的脑损伤和长期神经发育结果。然而，有证据表明 RI 升高可能表明存在具有血流动力学意义的 PDA。讨论 没有明确的证据支持常规测定脑动脉中的 RI 或其他多普勒参数以预测早产儿的脑损伤和长期神经发育结果。然而，有证据表明 RI 升高可能表明存在具有血流动力学意义的 PDA。讨论 没有明确的证据支持常规测定脑动脉中的 RI 或其他多普勒参数以预测早产儿的脑损伤和长期神经发育结果。然而，有证据表明 RI 升高可能表明存在具有血流动力学意义的 PDA。