Resumen de Doppler transcraneal en neonatos con hidrocefalia como predictor de hipertensión endocraneal. Instituto Autónomo Hospital Universitario de Los Andes. Octubre 2022-julio 2023 Transcranial doppler in neonates with hydrocephalis as a predictor of endocranial hypertension. Autonomous Institute University Hospital of Los Andes. October 2022-july 2023
- español
Introducción: los neonatos con hidrocefalia presentan incremento de la presión intracraneal (PIC), la cual requiere ser monitoreada. La medición de la PIC implica usar métodos invasivos, que son costosos y poco prácticos en la clínica diaria. Por ello, existen formas de valorar la PIC en forma no invasiva, con la estimación ultrasonográfica de la velocidad del flujo cerebral y los índices que se construyen a partir de las mismas (pulsatilidad y resistencia, entre otros). Objetivo: determinar la sensibilidad del Doppler transcraneal como predictor de hipertensión intracraneal en neonatos con y sin hidrocefalia en el área de Neonatología del Instituto Autónomo Hospital Universitario de Los Andes (IAHULA), octubre 2022-julio 2023. Método: estudio analítico transversal. Resultados: las mediciones ultrasonográficas en RN con hidrocefalia pueden ser de utilidad diagnóstica. Se obtuvo que los índices de pulsatilidad de las ACA y ACM se asociaron en forma significativa con el diagnóstico previo de hidrocefalia; mientras que los índices de resistencia no lo estuvieron; siendo los valores de los índices de pulsatilidad para la ACA de 1,43 ± 0,34 en los RN con diagnóstico previo de hidrocefalia y 1,03 ± 0,10 en los controles; mientras que, para la ACM, fueron de 1,45 ± 0,49 y 1,04 ± 0,94; respectivamente. Conclusión: los resultados sugieren que más que el tamaño ventricular, son los cambios de la hemodinámica vascular cerebral, los que pudieran ser adecuados como predictor de HIC en hidrocefalia neonatal.Introduction: neonates with hydrocephalus present increased intracranial pressure (ICP), which requires monitoring. Measuring ICP involves using invasive methods, which are expensive and impractical in daily clinical practice. Therefore, there are ways to assess ICP non-invasively, with ultrasonographic estimation of cerebral flow velocity and the indices that are constructed from them (pulsatility and resistance, among others). Objective: determine the sensitivity of transcranial Doppler as a predictor of intracranial hypertension in neonates with and without hydrocephalus in the Neonatology area of the Autonomous Institute University Hospital of Los Andes (IAHULA), October 2022-July 2023. Method: cross-sectional analytical study. Results: Ultrasonographic measurements in newborns with hydrocephalus may be of diagnostic utility. It was found that the pulsatility indices of the ACA and MCA were significantly associated with the previous diagnosis of hydrocephalus; while resistance indices were not; the values of the pulsatility indexes for the ACA were 1.43 ± 0.34 in the NB with a previous diagnosis of hydrocephalus and 1.03 ± 0.10 in the controls; while, for the MCA, they were 1.45 ± 0.49 and 1.04 ± 0.94; respectively. Conclusion: the results suggest that more than ventricular size, it is the changes in cerebral vascular hemodynamics that could be suitable as a predictor of ICH in neonatal hydrocephalus.Recibido: 05-09-2024Aprobado: 10-10-2024Publicado: 01-11-2024
- English
Introduction: neonates with hydrocephalus present increased intracranial pressure (ICP), which requires monitoring. Measuring ICP involves using invasive methods, which are expensive and impractical in daily clinical practice. Therefore, there are ways to assess ICP non-invasively, with ultrasonographic estimation of cerebral flow velocity and the indices that are constructed from them (pulsatility and resistance, among others). Objective: determine the sensitivity of transcranial Doppler as a predictor of intracranial hypertension in neonates with and without hydrocephalus in the Neonatology area of the Autonomous Institute University Hospital of Los Andes (IAHULA), October 2022-July 2023. Method: cross-sectional analytical study. Results: Ultrasonographic measurements in newborns with hydrocephalus may be of diagnostic utility. It was found that the pulsatility indices of the ACA and MCA were significantly associated with the previous diagnosis of hydrocephalus; while resistance indices were not; the values of the pulsatility indexes for the ACA were 1.43 ± 0.34 in the NB with a previous diagnosis of hydrocephalus and 1.03 ± 0.10 in the controls; while, for the MCA, they were 1.45 ± 0.49 and 1.04 ± 0.94; respectively. Conclusion: the results suggest that more than ventricular size, it is the changes in cerebral vascular hemodynamics that could be suitable as a predictor of ICH in neonatal hydrocephalus.
