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Circulatory Changes and Cerebral Blood Flow and Oxygenation During Transition in Newborns With Congenital Heart

Shabnam Peyvandi1, Mary T Donofrio2

  • 1Division of Pediatric Cardiology, University of California San Francisco, Pediatric Heart Center, Benioff Children's Hospital, San Francisco, CA.

Seminars in Pediatric Neurology
|December 8, 2018
PubMed

Insights

Infants with congenital heart disease (CHD) face brain risks during cardiovascular transition. Optimizing blood flow and oxygenation during this period can improve neurodevelopmental outcomes for these neonates.

Area of Science:

  • Neonatal neurology
  • Pediatric cardiology
  • Fetal development

Background:

  • Congenital heart disease (CHD) poses risks to neonatal brain development.
  • The transition from fetal to neonatal circulation presents unique vulnerabilities.
  • Brain development issues in fetuses with CHD can be identified before birth.

Purpose of the Study:

  • To review the impact of cardiovascular transition on the brain in infants with CHD.
  • To highlight neonatal brain vulnerabilities during the perinatal period.
  • To propose management strategies for improving neurodevelopmental outcomes in infants with CHD.

Main Methods:

  • Review of existing literature on cardiovascular transition and neonatal brain injury in CHD.
  • Analysis of hemodynamic changes affecting cerebral blood flow and oxygenation.
  • Identification of perinatal factors influencing neurodevelopment.

Main Results:

  • Neonates with critical CHD are susceptible to brain injury even before surgery.
  • Hemodynamic shifts during transition can compromise cerebral blood flow and oxygenation.
  • Delayed brain development is observed in fetuses with certain CHD types.

Conclusions:

  • Perinatal management strategies are crucial for optimizing neurodevelopmental potential in infants with CHD.
  • Tailored strategies focusing on hemodynamic stability, particularly cerebral blood flow and oxygenation, are recommended.
  • Early identification and intervention can mitigate brain injury risks in neonates with CHD.

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