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The effect of phototherapy on cerebral blood flow velocity in preterm infants
M J Benders1, F van Bel, M van de Bor
1Department of Paediatrics, University Hospital Leiden, The Netherlands.
Insights
Phototherapy for jaundice in preterm infants significantly increases cerebral blood flow velocity. This effect persists in ventilated infants after treatment cessation, unlike in healthy infants.
Area of Science:
- Neonatal Medicine
- Pediatric Cardiology
- Medical Imaging
Background:
- Non-haemolytic hyperbilirubinaemia is common in preterm infants.
- Phototherapy using blue light is a standard treatment for neonatal jaundice.
- Potential effects of phototherapy on cerebral hemodynamics require further investigation.
Purpose of the Study:
- To investigate the impact of phototherapy on cerebral blood flow velocity in preterm infants.
- To assess the reversibility of phototherapy-induced hemodynamic changes after treatment discontinuation.
- To explore the influence of ductus arteriosus patency and ventilation status on these changes.
Main Methods:
- Two-dimensional/pulsed Doppler ultrasound was used to measure cerebral blood flow velocity.
- Measurements were taken before, during, and after phototherapy in 22 preterm infants (gestational age ≤32 weeks).
- Doppler echocardiography assessed ductus arteriosus patency; brain ultrasounds confirmed normal findings.
Main Results:
- Mean cerebral blood flow velocity significantly increased after initiating phototherapy.
- In non-ventilated infants, velocities returned to baseline post-phototherapy.
- In ventilated infants, velocities remained elevated; 10 infants showed ductus arteriosus reopening during treatment.
Conclusions:
- Phototherapy significantly alters cerebral blood flow velocity in preterm infants.
- Ventilation status influences the recovery of cerebral hemodynamics after phototherapy.
- Ductus arteriosus patency may mediate cerebral blood flow changes during phototherapy.
Abstract:
Cerebral blood flow velocity was studied with two-dimensional/pulsed Doppler ultrasound before, during and after discontinuation of phototherapy in 22 preterm infants (gestational age < or =32 weeks), who were treated for a minimum of 12h with blue-light phototherapy for non-haemolytic hyperbilirubinaemia. Before the cerebral blood flow velocity measurements, patency of the ductus arteriosus was diagnosed by Doppler echocardiography. All infants had normal brain ultrasound scans. Mean cerebral blood flow velocity increased significantly after initiation of phototherapy in all infants. Only in "healthy" (non-ventilated) infants did cerebral blood flow velocity return to pre-phototherapy values (baseline) after discontinuation of phototherapy, whereas in "unhealthy" (ventilated) infants cerebral blood flow velocity did not return to baseline. In 10 infants the ductus arteriosus reopened during phototherapy. In those infants, mean cerebral blood flow velocity returned to pre-phototherapy values after 2 h of phototherapy prior to its discontinuation.