Evaluation of cerebral electrical activity and cardiac output after patent ductus arteriosus ligation in preterm infants.

OBJECTIVE: To characterize and investigate the relationship between systemic blood flow and pre- and postoperative cerebral electrical activity in preterm neonates undergoing patent ductus arteriosus (PDA) ligation.

STUDY DESIGN: A prospective observational study was conducted in 17 preterm neonates undergoing PDA ligation. All infants had amplitude-integrated electroencephalography (aEEG) recorded continuously from 4 h preoperatively to 24 h postoperatively. Targeted neonatal echocardiography was performed to evaluate myocardial performance and systemic blood flow at four sequential time points: preoperatively; 1, 8 and 24 h postoperatively.

RESULT: PDA ligation was followed by a fall in the lower border of the aEEG trace lower left ventricular output, but recovery of diastolic flow in the middle cerebral artery. Altered lower margin was associated with gestational age and PDA diameter on univariate analysis, but not with low cardiac output.

CONCLUSION: PDA ligation was associated with altered cerebral electrical activity, although these changes were not related to low cardiac output state.